Individual provider Active NPI

Jennifer S Desmond, FNP

  • Nurse Practitioner
  • Vinalhaven, ME
National Provider Identifier
1851480305
Registry record updated Jan 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
R052901 Issued in ME
Practice address
15 Medical Center Loop
Vinalhaven, ME 04863
Phone
(207) 863-4341
Fax
(207) 863-9358
NPI assigned
Oct 12, 2006
Last updated
Jan 29, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X R052901 ME Primary

Addresses

Primary practice location

15 Medical Center Loop
Vinalhaven, ME 04863

Mailing address

15 Medical Center Loop
Vinalhaven, ME 04863
Phone (207) 863-4341

Other identifiers 1

IdentifierTypeStateIssuer
432341699MedicaidME

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
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

Enrollment IDStateProvider typePAC IDDetails
I20061109000418 ME Practitioner - Nurse Practitioner 7113925900 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Johns Hopkins University School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Islands Community Medical Services IncGroup PAC ID 9638088115, 6 clinicians

Practice addresses (Care Compare)

15 Medical Ctr Loop
Vinalhaven, ME 04863

15 Medical Ctr Loop
Vinalhaven, ME 04863-4119
Phone (207) 863-4341

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Islands Community Medical Services Inc CurrentSince Sep 5, 2006 Accepting new patients

Locations

15 Medical Center Loop
Vinalhaven, ME 04863
Phone (207) 863-4341

Interoperability endpoints

  • Direct secure messaging: jennifer.desmond.p1@direct.hhcme.nextgenshare.com

Organizations & group practices 1

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

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390953600000",
    "number": "1851480305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 MEDICAL CENTER LOOP",
            "city": "VINALHAVEN",
            "state": "ME",
            "postal_code": "04863",
            "telephone_number": "207-863-4341",
            "fax_number": "207-863-9358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 MEDICAL CENTER LOOP",
            "city": "VINALHAVEN",
            "state": "ME",
            "postal_code": "04863",
            "telephone_number": "207-863-4341",
            "fax_number": "207-863-9358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESMOND",
        "first_name": "JENNIFER",
        "middle_name": "S",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-12",
        "last_updated": "2014-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "ME",
            "license": "R052901",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "432341699",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vinalhaven, ME

Sources for this page

Verify at the official NPI Registry.