Peggy J Jansen, CNP, FNP-C
Individual provider Active NPI Primary Care Nurse Practitioner · Sioux Falls, SD
NPI 1992210355 · NPPES record last updated Dec 18, 2024
Key facts
- NPI
- 1992210355
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Primary Care Nurse Practitioner 363LP2300X
- License
- CP001314 (SD)
- Practice address
- 4500 W 69TH St
Sioux Falls, SD 57108-8148 - Phone
- (605) 977-7000
- Fax
- (605) 977-7001
- NPI assigned
- Dec 7, 2017
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in SD
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180314002713 | SD | Practitioner - Nurse Practitioner | 4284996018 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Certified Nurse Practitioner, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CP001314 | SD | MD | Primary Care Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Heart Hospital of South Dakota LLC | Current |
Accepting new patients | |
| Heart Hospital of South Dakota LLC | Current |
Accepting new patients |
Locations
4500 W 69th St
Sioux Falls, SD 57108
Phone (605) 977-7000
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Nurse Practitioner | 363LP2300X | CP001314 | SD | Yes |
Addresses
Primary practice location
4500 W 69TH St
Sioux Falls, SD 57108-8148
Mailing address
2165 Promise Rd
Rapid City, SD 57701-8981
Phone (605) 718-1095
Other providers in Sioux Falls, SD
- Tammy Jo Jans
- Ashley Lynn Jansen
- Brynna Jansen
- Chandler Jansen
- Madisyn Elizabeth Jansen
- Tarryn Jansen
- Christopher Janssen
- Fanny M Jaquez
- Jennifer Ann Jarding
- Jennifer Lynn Jarding
All providers in Sioux Falls, SD · Primary Care Nurse Practitioner in South Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 18, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.