Active NPI
Jennifer K Davis
- Pediatric Nurse Practitioner
- Elgin, IL
National Provider Identifier
1891095923
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- 041332139
- Practice address
- 1015 Summit St
Elgin, IL 60120-4362 - Phone
- (847) 742-6888
- NPI assigned
- Oct 22, 2010
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | 041332139 | IL | Primary |
Addresses
Primary practice location
1015 Summit St
Elgin, IL 60120-4362
Mailing address
1015 Summit St
Elgin, IL 60120-4362
Phone (847) 742-6888
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | jdavis287609@direct.myadvocateaurora.org | Direct | |
| FHIR URL | https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2? |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 041332139 | IL | MD | Pediatric Nurse Practitioner |
Interoperability endpoints
- jdavis287609@direct.myadvocateaurora.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1287705600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1642032000000",
"number": "1891095923",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1015 SUMMIT ST",
"city": "ELGIN",
"state": "IL",
"postal_code": "601204362",
"telephone_number": "847-742-6888"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1015 SUMMIT ST",
"city": "ELGIN",
"state": "IL",
"postal_code": "601204362",
"telephone_number": "847-742-6888"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "JENNIFER",
"middle_name": "K",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-10-22",
"last_updated": "2022-01-13",
"certification_date": "2022-01-13",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "IL",
"license": "041332139",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "jdavis287609@direct.myadvocateaurora.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "1015 Summit St",
"city": "Elgin",
"state": "IL",
"country_code": "US",
"postal_code": "601204362",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2?",
"affiliation": "N",
"address_1": "1015 Summit St",
"city": "Elgin",
"state": "IL",
"country_code": "US",
"postal_code": "601204362",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Elgin, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 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.