Individual provider Active NPI

Jenna Nicole Stowers, APRN-FPA, FNP-C

  • Family Nurse Practitioner
  • Mt Zion, IL
National Provider Identifier
1912476599
Registry record updated Aug 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
277001575 Issued in IL
Practice address
100 Lewis Park Dr
Mt Zion, IL 62549-1202
Phone
(217) 855-7447
Fax
(888) 774-7504
NPI assigned
Nov 13, 2018
Last updated
Aug 27, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 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 277001575 IL Primary

Addresses

Primary practice location

100 Lewis Park Dr
Mt Zion, IL 62549-1202

Mailing address

6330 Maple Crest CT
Decatur, IL 62521-8782
Phone (217) 855-8901

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20181228000644 IL Practitioner - Nurse Practitioner 2062757750

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
277001575ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Decatur Memorial Hospital CurrentSince Nov 26, 2018 Accepting new patients
Decatur Memorial Hospital CurrentSince Nov 26, 2018 Accepting new patients
Steller Wellness PastSince Oct 1, 2023 Accepting new patients

Locations

2300 N Edward St
Decatur, IL 62526
Phone (217) 876-3000

4775 E Maryland St
Decatur, IL 62521
Phone (217) 864-2700

241 W Weaver Rd
Ste 145B
Forsyth, IL 62535
Phone (217) 876-5220

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1542067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724716800000",
    "number": "1912476599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6330 MAPLE CREST CT",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625218782",
            "telephone_number": "217-855-8901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 LEWIS PARK DR",
            "city": "MT ZION",
            "state": "IL",
            "postal_code": "625491202",
            "telephone_number": "217-855-7447",
            "fax_number": "888-774-7504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOWERS",
        "first_name": "JENNA",
        "middle_name": "NICOLE",
        "credential": "APRN-FPA, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-13",
        "last_updated": "2024-08-27",
        "certification_date": "2024-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "277001575",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mt Zion, IL

Sources for this page

Verify at the official NPI Registry.