Individual provider Active NPI

Jennifer M Kammer, ARNP

  • Family Nurse Practitioner
  • Moline, IL
National Provider Identifier
1982971115
Registry record updated Apr 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209009140 Issued in IL
Practice address
350 John Deere Rd
Moline, IL 61265-6899
Phone
(309) 743-6700
Fax
(309) 743-6709
NPI assigned
Nov 16, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2021

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 209009140 IL Primary

Addresses

Primary practice location

350 John Deere Rd
Moline, IL 61265-6899

Mailing address

350 John Deere Rd
Moline, IL 61265-6899
Phone (309) 743-6700

Other names 1

  • Jennifer M Johnson Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jennifer.kammer@direct.genesishealth.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20140321000342 IA Practitioner - Nurse Practitioner 2062671035 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Genesis Health SystemGroup PAC ID 7214841436, 217 clinicians

Practice addresses (Care Compare)

2140 53Rd Ave
Bettendorf, IA 52722-6279
Phone (563) 421-5700

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Genesis Health System CurrentSince Feb 3, 2014 Accepting new patients
Genesis Health System CurrentSince Feb 3, 2014 Accepting new patients

Locations

2140 53rd Ave
Bettendorf, IA 52722
Phone (563) 421-5700

1351 W Central Park Ave
Ste 4100
Davenport, IA 52804
Phone (563) 355-9191

210 W 53rd St
Davenport, IA 52806
Phone (563) 386-3436

1345 W Central Park Ave
Davenport, IA 52804
Phone (563) 421-4400

619 5th St
Durant, IA 52747
Phone (563) 785-4487

Interoperability endpoints

  • Direct secure messaging: jennifer.kammer@direct.genesishealth.com

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 and National Provider Directory roles.

Hospital & facility affiliations 5

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": "1321401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619740800000",
    "number": "1982971115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 JOHN DEERE RD",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612656899",
            "telephone_number": "309-743-6700",
            "fax_number": "309-743-6709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 JOHN DEERE RD",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612656899",
            "telephone_number": "309-743-6700",
            "fax_number": "309-743-6709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAMMER",
        "first_name": "JENNIFER",
        "middle_name": "M",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-16",
        "last_updated": "2021-04-30",
        "certification_date": "2021-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209009140",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jennifer.kammer@direct.genesishealth.com",
            "affiliation": "N",
            "endpointDescription": "Genesis Health System Direct Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "1345 W Central Park Ave",
            "city": "Davenport",
            "state": "IA",
            "country_code": "US",
            "postal_code": "528041844",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "JOHNSON",
            "middle_name": "M",
            "credential": "ARNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Moline, IL

Sources for this page

Verify at the official NPI Registry.