Jennifer L Fasano, APN

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

209007750 Issued in IL

Practice address

444 Roxbury Rd
Rockford, IL 61107-5059

Phone

(815) 398-3000

NPI assigned

Jun 16, 2010

Last updated

Jun 16, 2010By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Jennifer Simmons Former name

Medicare fee-for-service enrollment

Enrolled in IL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Vpa PC

  dba HarmonyCares Medical Group

  • Family Medicine Physician
  • Oakbrook Terrace, IL
  • NPI 1174925663
  Medicare reassignment NPD
• Vpa PC

  dba HarmonyCares Medical Group

  • Family Medicine Physician
  • Brentwood, TN
  • NPI 1578363362
  NPD

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

{
    "created_epoch": "1276646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1276646400000",
    "number": "1902127749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "444 ROXBURY RD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611075059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "444 ROXBURY RD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611075059",
            "telephone_number": "815-398-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FASANO",
        "first_name": "JENNIFER",
        "middle_name": "L",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-16",
        "last_updated": "2010-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209007750",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "SIMMONS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Iris Ellen Fanning
• Chenelle Renee Fanouth, PHARMD
• Fareha N. Malik, M.D. LLC
• Farhad Farokhi, DO
• Kari Elizabeth Farthing, MA CCC-SLP
• Kehinde John Fasanya, DDS
• Erin Fasula, PT, MPT
• Arooj Fatima, M.D
• Edward D Fausel, MD
• Kelsey Fausel, PHARMD

• Nurse Practitioner in Rockford, IL
• Providers in Rockford, IL by specialty
• Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2010; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.