Active NPI
Jodie Beth Pezzner, ANP-C
- Nurse Practitioner
- Wilmington, DE
National Provider Identifier
1972651099
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- LB0000103
- Practice address
- 501 W 14TH St
Wilmington, DE 19801-1013 - Phone
- (302) 428-4251
- Fax
- (302) 428-4280
- NPI assigned
- Jan 8, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | LB0000103 | DE | Primary |
Addresses
Primary practice location
501 W 14TH St
Wilmington, DE 19801-1013
Mailing address
1513 Broad Run Rd
Landenberg, PA 19350-1330
Phone (610) 274-8098
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LB0000103 | DE | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168214400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1972651099",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1513 BROAD RUN RD",
"city": "LANDENBERG",
"state": "PA",
"postal_code": "193501330",
"telephone_number": "610-274-8098",
"fax_number": "302-428-4280"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "501 W 14TH ST",
"city": "WILMINGTON",
"state": "DE",
"postal_code": "198011013",
"telephone_number": "302-428-4251",
"fax_number": "302-428-4280"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEZZNER",
"first_name": "JODIE",
"middle_name": "BETH",
"name_prefix": "Ms.",
"credential": "ANP-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-08",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "DE",
"license": "LB0000103",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wilmington, DE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.