Individual provider Active NPI

Jennifer Lori Somerville, ARNP

  • Nurse Practitioner
  • Cedar Rapids, IA
National Provider Identifier
1851957732
Registry record updated May 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
F04190285 Issued in IA
Practice address
701 10TH St SE
Cedar Rapids, IA 52403-1251
Phone
(319) 369-4652
NPI assigned
May 15, 2019
Last updated
May 15, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2019

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 F04190285 IA Primary

Addresses

Primary practice location

701 10TH St SE
Cedar Rapids, IA 52403-1251

Mailing address

701 10TH St SE
Cedar Rapids, IA 52403-1251
Phone (319) 369-4652

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20190718003519 IA Practitioner - Nurse Practitioner 3678809266 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Medical CenterGroup PAC ID 4183535271, 295 clinicians

Practice addresses (Care Compare)

701 10TH St SE
Cedar Rapids, IA 52403-1251

701 10TH St SE
Cedar Rapids, IA 52403-1292

701 10TH St SE J Edward Lundy
Mercy Pediatric Clinic
Cedar Rapids, IA 52403-1251
Phone (319) 832-2328

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
F04190285IAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Medical Center CurrentSince Jun 9, 2019 Accepting new patients
Mercy Medical Center Nurse Practitioner CurrentSince Jun 9, 2019 Accepting new patients
Mercy Medical Center Current Accepting new patients

Locations

701 10th St SE
Cedar Rapids, IA 52403
Phone (319) 398-6011

Organizations & group practices 3

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": "1557878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557878400000",
    "number": "1851957732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 10TH ST SE",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524031251",
            "telephone_number": "319-369-4652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 10TH ST SE",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524031251",
            "telephone_number": "319-369-4652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOMERVILLE",
        "first_name": "JENNIFER",
        "middle_name": "LORI",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-15",
        "last_updated": "2019-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IA",
            "license": "F04190285",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedar Rapids, IA

Sources for this page

Verify at the official NPI Registry.