Individual provider Active NPI

Jenny Gaworski, FNP,BC

  • Family Nurse Practitioner
  • Princeton, IL
National Provider Identifier
1942551312
Registry record updated Nov 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209009747 Issued in IL
Practice address
530 Park Ave E
Princeton, IL 61356-3901
Phone
(815) 875-8666
Fax
(815) 872-0487
NPI assigned
Sep 26, 2012
Last updated
Nov 5, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2012

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 209009747 IL Primary

Addresses

Primary practice location

530 Park Ave E
Princeton, IL 61356-3901

Mailing address

530 Park Ave E
Princeton, IL 61356-3901
Phone (815) 875-8886

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
I20130114000076 IL Practitioner - Nurse Practitioner 6901059419 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Osf Multi-Specialty GroupGroup PAC ID 3678889789, 2,123 clinicians

Practice addresses (Care Compare)

1304 Gemini Cir
Suite 1
Ottawa, IL 61350-1690
Phone (815) 434-0276

8600 State Route 91
Suite 130
Peoria, IL 61615-7829
Phone (309) 683-5050

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209009747ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Central PA Pharmacy LLC. Current Accepting new patients
Osf Multi-Specialty Group CurrentSince Jun 19, 2023 Accepting new patients

Locations

1405 E 12th St
Ste 200
Mendota, IL 61342
Phone (815) 431-3274

1304 Gemini Cir
Ste 1
Ottawa, IL 61350
Phone (815) 433-9666

1420 W Pioneer Pkwy
Peoria, IL 61615
Phone (309) 308-5195

8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050

530 Park Ave E
Princeton, IL 61356
Phone (815) 875-2811

530 Park Ave E
Ste 207
Princeton, IL 61356
Phone (815) 875-8666

530 Park Ave E
Ste 306
Princeton, IL 61356
Phone (815) 875-4531

Interoperability endpoints

  • Direct secure messaging: jennygaworski@agc.allscriptsdirect.net

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1348617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352073600000",
    "number": "1942551312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 PARK AVE E",
            "city": "PRINCETON",
            "state": "IL",
            "postal_code": "613563901",
            "telephone_number": "815-875-8886",
            "fax_number": "815-872-0487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 PARK AVE E",
            "city": "PRINCETON",
            "state": "IL",
            "postal_code": "613563901",
            "telephone_number": "815-875-8666",
            "fax_number": "815-872-0487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAWORSKI",
        "first_name": "JENNY",
        "name_prefix": "Mrs.",
        "credential": "FNP,BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-26",
        "last_updated": "2012-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209009747",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Princeton, IL

Sources for this page

Verify at the official NPI Registry.