Individual provider Active NPI

Jennie Catherine Vegard, NURSE PRACTITIONER

  • Adult Health Nurse Practitioner
  • Canandaigua, NY
National Provider Identifier
1982643813
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
F301123-1 Issued in NY
Practice address
400 Fort Hill Ave
Canandaigua, NY 14424-1159
Phone
(585) 393-7784
Fax
(585) 393-8334
NPI assigned
Jun 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X F301123-1 NY Primary

Addresses

Primary practice location

400 Fort Hill Ave
Canandaigua, NY 14424-1159

Mailing address

5090 Parrish Street Ext
Canandaigua, NY 14424-9178
Phone (585) 393-7784

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F301123-1NYMDAdult Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1982643813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5090 PARRISH STREET EXT",
            "city": "CANANDAIGUA",
            "state": "NY",
            "postal_code": "144249178",
            "telephone_number": "585-393-7784",
            "fax_number": "585-393-8334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 FORT HILL AVE",
            "city": "CANANDAIGUA",
            "state": "NY",
            "postal_code": "144241159",
            "telephone_number": "585-393-7784",
            "fax_number": "585-393-8334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VEGARD",
        "first_name": "JENNIE",
        "middle_name": "CATHERINE",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-06",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F301123-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canandaigua, NY

Sources for this page

Verify at the official NPI Registry.