Individual provider Active NPI

Nicole Rae Jennings, FNP-C

  • Family Nurse Practitioner
  • Springfield, MO
National Provider Identifier
1902677537
Registry record updated Jan 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F01240463 Issued in MO
Practice address
2115 S Fremont Ave Ste 5000
Springfield, MO 65804-2230
Phone
(417) 820-3192
NPI assigned
Jan 11, 2024
Last updated
Jan 11, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F01240463 MO Primary

Addresses

Primary practice location

2115 S Fremont Ave Ste 5000
Springfield, MO 65804-2230

Mailing address

2115 S Fremont Ave Ste 5000
Springfield, MO 65804-2230

Other practice location 1

1235 E Cherokee St
Springfield, MO 65804-2203
Phone (417) 820-2000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20240220001185 MO Practitioner - Nurse Practitioner 9335583269 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinic Springfield CommunitiesGroup PAC ID 7416865845, shared by 26 NPIs, 1,121 clinicians

Practice addresses (Care Compare)

2115 S Fremont Ave
5000 MC Cardiac Thoracic and Vasc Surgery
Springfield, MO 65804-2230
Phone (417) 820-3960

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F01240463MOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Hospital Springfield Current Accepting new patients
Mercy Clinic Springfield Communities CurrentSince Feb 19, 2024 Accepting new patients
Mercy Clinic Springfield Communities CurrentSince Feb 19, 2024 Accepting new patients
Mercy Clinic Springfield Communities Family CurrentSince Feb 19, 2024 Accepting new patients
Ozarks Medical Center Past Accepting new patients
Lester E Cox Medical Centers Past Accepting new patients

Locations

1605 Martin Springs Dr
Rolla, MO 65401
Phone (573) 458-6379

1235 E Cherokee St
Springfield, MO 65804
Phone (417) 820-2115

2115 S Fremont Ave
Ste 3050
Springfield, MO 65804
Phone (417) 820-3905

2115 S Fremont Ave
Ste 5000
Springfield, MO 65804
Phone (417) 820-3912

Organizations & group practices 6

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 3

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": "1704931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704931200000",
    "number": "1902677537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2115 S FREMONT AVE STE 5000",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658042230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2115 S FREMONT AVE STE 5000",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658042230",
            "telephone_number": "417-820-3192"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1235 E Cherokee St",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "MO",
            "postal_code": "658042203",
            "country_code": "US",
            "telephone_number": "417-820-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JENNINGS",
        "first_name": "NICOLE",
        "middle_name": "RAE",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-11",
        "last_updated": "2024-01-11",
        "certification_date": "2024-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "F01240463",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MO

Sources for this page

Verify at the official NPI Registry.