Jacquelyn Joyce Rognstad, BSN, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

041.395865 Issued in IL

Practice address

81 E Grand Ave
Fox Lake, IL 60020-1557

Phone

(224) 908-3005

Fax

(815) 814-8989

NPI assigned

Apr 27, 2017

Last updated

Nov 29, 2017By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor on Science - Nursing, Registered Nurse

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1493251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1511913600000",
    "number": "1770018780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38675 N HILLTOP AVE",
            "city": "ANTIOCH",
            "state": "IL",
            "postal_code": "600029630",
            "telephone_number": "847-395-4557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "81 E GRAND AVE",
            "city": "FOX LAKE",
            "state": "IL",
            "postal_code": "600201557",
            "telephone_number": "224-908-3005",
            "fax_number": "815-814-8989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROGNSTAD",
        "first_name": "JACQUELYN",
        "middle_name": "JOYCE",
        "credential": "BSN, RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-04-27",
        "last_updated": "2017-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041.395865",
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1770018780",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pinto-Thomas, M.D., S.C.
• Michelle Renee Ponselle-Mays, MS, OTR/L
• Thomas Love Prendergast
• Stephanie Lynn Provis
• Amanda Reising, PHARMD
• Esmeralda Roxas
• Stephen Rudawski, BSPHARM
• Rosanna Valino Santos, APN NP-C
• Boyana Scekic, MOT
• Martina Schmidt, LMT

• Registered Nurse in Fox Lake, IL
• Providers in Fox Lake, IL by specialty
• Registered Nurse in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.