Jennifer S Pemble, NNP-BC

Primary specialty

Neonatal Nurse PractitionerTaxonomy code 363LN0000X

License

209009760 Issued in IL

Practice address

611 W Park St
Urbana, IL 61801-2529

Phone

(217) 383-3266

Fax

(217) 383-3463

NPI assigned

Sep 19, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Jennifer S Gibbs Former name

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jpembleaprn344058@carlehiedirect.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Carle Bromenn Medical Center

  • Clinic/Center
  • Normal, IL
  • NPI 1104442615
  Medicare reassignment NPD
• Carle Health Care Incorporated

  • Internal Medicine Physician
  • Urbana, IL
  • NPI 1154653947
  Medicare reassignment NPD
• Carle West Physician Group Inc

  • Family Medicine Physician
  • Normal, IL
  • NPI 1467074138
  Medicare reassignment NPD
• Memorial Physician Services

  • Family Medicine Physician
  • Springfield, IL
  • NPI 1174877930
  Medicare reassignment NPD
• Carle Bromenn Medical Center

  • General Acute Care Hospital
  • Normal, IL
  • NPI 1962424036
  NPD
• Family Medical Center of Chatham, LLC

  • Family Medicine Physician
  • Chatham, IL
  • NPI 1992956528
  NPD
• Memorial Physician Services

  • Multi-Specialty Clinic/Center
  • Springfield, IL
  • NPI 1417922964
  NPD
• Memorial Physician Services

  • Rural Health Clinic/Center
  • Jacksonville, IL
  • NPI 1528741147
  NPD
• Siu Physicians & Surgeons, Inc

  • Pediatrics Physician
  • Springfield, IL
  • NPI 1285657379
  NPD (past)

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

{
    "created_epoch": "1348012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652918400000",
    "number": "1811248651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 W PARK ST",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "618012529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 W PARK ST",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "618012529",
            "telephone_number": "217-383-3266",
            "fax_number": "217-383-3463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEMBLE",
        "first_name": "JENNIFER",
        "middle_name": "S",
        "credential": "NNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-19",
        "last_updated": "2022-05-19",
        "certification_date": "2022-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "MO",
            "license": "2020010760",
            "primary": false
        },
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "IL",
            "license": "209009760",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "GIBBS",
            "middle_name": "S",
            "credential": "NNP-BC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Mary Payne
• Jennifer Pearman, PA
• Peggy D Pearson, MD
• Richard Pearson, MD
• Ryan Peddy
• Marilyn Perez, NP-C
• Miriam Perez
• Lisa Perry, MSQMHP
• Personal Performance Training & Rehabiliation, Inc.
• Persons Assuming Control of Their Environment

• Neonatal Nurse Practitioner in Urbana, IL
• Providers in Urbana, IL by specialty
• Neonatal Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.