Active NPI
Jerri Jakich-Ortiz, MS
- Family Nurse Practitioner
- Crown Point, IN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 71003055A
- Practice address
- 2100 N Main St Ste 304
Crown Point, IN 46307-1877 - Phone
- (574) 546-1900
- Fax
- (574) 546-1999
- NPI assigned
- Sep 9, 2009
- 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 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 28090074A | IN | |
| Nurse Practitioner | 363L00000X | 71003055A | IN | |
| Family Nurse Practitioner | 363LF0000X | 71003055B | IN | |
| Family Nurse Practitioner | 363LF0000X | 71003055A | IN | Primary |
Addresses
Primary practice location
2100 N Main St Ste 304
Crown Point, IN 46307-1877
Mailing address
PO Box 10299
Fort Wayne, IN 46851-0299
Phone (574) 546-1900
Other practice location 1
320 W 61st Ave
Hobart, IN 46342-6490
Phone (219) 947-6839
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2100 N Main St
Suite 304
Crown Point, IN 46307-1877
Phone (574) 546-1900
Merit-based Incentive Payment System (MIPS)
- Final score
- 93.06 of 100
- Quality
- 80.07
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 28090074A | IN | MD | Registered Nurse |
| 71003055B | IN | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Neurology and Pain Management Associates PC | Nurse Practitioner | Current | Accepting new patients |
Locations
601 W County Road 200 S
New Castle, IN 47362
Phone (765) 529-5796
20 John Kissinger Dr
Wabash, IN 46992
Phone (260) 274-0444
851 Kimsey Ln
Henderson, KY 42420
Phone (270) 295-6450
50 Sanderson Ln
Coldwater, MI 49036
Phone (517) 279-9587
41000 W 13 Mile Rd
Novi, MI 48377
Phone (248) 360-4327
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 and National Provider Directory roles.
-
- Internal Medicine Physician
- Crown Point, IN
- NPI 1518900620
Nurse Practitioner
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1252454400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1616630400000",
"number": "1891028833",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 10299",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468510299",
"telephone_number": "574-546-1900",
"fax_number": "574-546-1999"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2100 N MAIN ST STE 304",
"city": "CROWN POINT",
"state": "IN",
"postal_code": "463071877",
"telephone_number": "574-546-1900",
"fax_number": "574-546-1999"
}
],
"practiceLocations": [
{
"address_1": "320 W 61st Ave",
"address_purpose": "LOCATION",
"city": "Hobart",
"state": "IN",
"postal_code": "463426490",
"country_code": "US",
"telephone_number": "219-947-6839",
"fax_number": "219-947-6839",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JAKICH-ORTIZ",
"first_name": "JERRI",
"credential": "MS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-09-09",
"last_updated": "2021-03-25",
"certification_date": "2021-03-25",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "IN",
"license": "28090074A",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "IN",
"license": "71003055A",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "IN",
"license": "71003055B",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "IN",
"license": "71003055A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Crown Point, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2021; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.