Individual provider Active NPI

Jenni Lou McCann, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Dubuque, IA
National Provider Identifier
1891371944
Registry record updated Oct 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
G162931 Issued in IA
Practice address
2600 Dodge St
Ste D5
Dubuque, IA 52003-7161
Phone
(563) 590-1399
NPI assigned
Mar 19, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 12, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X G162931 IA Primary

Addresses

Primary practice location

2600 Dodge St
Ste D5
Dubuque, IA 52003-7161

Mailing address

2600 Dodge St
Ste D5
Dubuque, IA 52003-7161
Phone (563) 590-1399

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL jenni.mccann@clarke.edu

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
I20210518000775 IA Practitioner - Nurse Practitioner 7315356698 Reassigns benefits to 1 organization
Practice locations: Dubuque, IA

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2600 Dodge St
Suite D5
Dubuque, IA 52003-7161
Phone (563) 590-1399

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
G162931IAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dr Jenni L McCann Corporation Psychiatric/Mental Health CurrentSince Oct 1, 2021 Accepting new patients

Locations

2600 Dodge St
Ste D5
Dubuque, IA 52003
Phone (563) 566-8890

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.

NPI Registry JSON

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

{
    "created_epoch": "1616112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633996800000",
    "number": "1891371944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 DODGE ST",
            "address_2": "STE D5",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "520037161",
            "telephone_number": "563-590-1399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 DODGE ST",
            "address_2": "STE D5",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "520037161",
            "telephone_number": "563-590-1399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCANN",
        "first_name": "JENNI",
        "middle_name": "LOU",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-19",
        "last_updated": "2021-10-12",
        "certification_date": "2021-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IA",
            "license": "G162931",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "jenni.mccann@clarke.edu",
            "affiliation": "N",
            "address_1": "2532 Queen St",
            "city": "Dubuque",
            "state": "IA",
            "country_code": "US",
            "postal_code": "520010617",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Dubuque, IA

Sources for this page

Verify at the official NPI Registry.