Active NPI
Jennifer D. Yeager
- Nurse Practitioner
- Roscoe, IL
National Provider Identifier
1811306673
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 5942-33
- Practice address
- 11534 Ridgecrest Dr
Roscoe, IL 61073-8111 - Phone
- (815) 713-6620
- NPI assigned
- Aug 6, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acute Care Nurse Practitioner | 363LA2100X | 5942-33 | WI | |
| Nurse Practitioner | 363L00000X | 5942-33 | WI | Primary |
Addresses
Primary practice location
11534 Ridgecrest Dr
Roscoe, IL 61073-8111
Mailing address
11534 Ridgecrest Dr
Roscoe, IL 61073-8111
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1407283200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1647388800000",
"number": "1811306673",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11534 RIDGECREST DR",
"city": "ROSCOE",
"state": "IL",
"postal_code": "610738111"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11534 RIDGECREST DR",
"city": "ROSCOE",
"state": "IL",
"postal_code": "610738111",
"telephone_number": "815-713-6620"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YEAGER",
"first_name": "JENNIFER",
"middle_name": "D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-08-06",
"last_updated": "2022-03-16",
"certification_date": "2022-03-16",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2100X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Acute Care",
"state": "WI",
"license": "5942-33",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "WI",
"license": "5942-33",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Roscoe, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.