Individual provider Active NPI

Jenna Schermerhorn, APN

  • Obstetrics & Gynecology Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1922499102
Registry record updated Dec 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology Nurse PractitionerTaxonomy code 363LX0001X
License
209.011907 Issued in IL
Practice address
680 N Lake Shore Dr Ste 824
Chicago, IL 60611-8702
Phone
(312) 943-3300
Fax
(312) 266-4591
NPI assigned
Feb 10, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Nurse Practitioner 363LX0001X 209.011907 IL Primary

Addresses

Primary practice location

680 N Lake Shore Dr Ste 824
Chicago, IL 60611-8702

Mailing address

680 N Lake Shore Dr
824
Chicago, IL 60611-4546

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
I20241111000649 IL Practitioner - Nurse Practitioner 8123552379 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209.011907ILMDObstetrics & Gynecology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeshore Obstetrics and Gynecology LLC CurrentSince Sep 2, 2024 Accepting new patients
Central Dupage Physician Group PastSince Sep 5, 2021 Accepting new patients

Locations

680 N Lake Shore Dr
Ste 824
Chicago, IL 60611
Phone (312) 943-3300

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.1576

Organizations & group practices 2

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": "1423526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702857600000",
    "number": "1922499102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "680 N LAKE SHORE DR",
            "address_2": "824",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606114546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "680 N LAKE SHORE DR STE 824",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606118702",
            "telephone_number": "312-943-3300",
            "fax_number": "312-266-4591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHERMERHORN",
        "first_name": "JENNA",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-10",
        "last_updated": "2023-12-18",
        "certification_date": "2023-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "IL",
            "license": "209.011907",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.