Active NPI
Jessica Lynn Yebernetsky, CRNP
- Nurse Practitioner
- Du Bois, PA
National Provider Identifier
1992213318
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- SP017845
- Practice address
- 123 Hospital Ave
Du Bois, PA 15801-1409 - Phone
- (814) 371-2922
- NPI assigned
- Jan 19, 2018
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | SP017845 | PA | |
| Nurse Practitioner | 363L00000X | SP017845 | PA | Primary |
Addresses
Primary practice location
123 Hospital Ave
Du Bois, PA 15801-1409
Mailing address
123 Hospital Ave
Du Bois, PA 15801-1409
Phone (814) 371-2922
Other practice location 1
100 N Academy Ave
Danville, PA 17822-9800
Phone (570) 271-6211
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | jyebernetsky160727@direct.geisinger.edu | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SP017845 | PA | MD | Pediatric Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dubois Regional Medical Center | Current | Accepting new patients | |
| Dubois Regional Medical Center | Nurse Practitioner | Current | Accepting new patients |
Locations
100 Hospital Ave
Dubois, PA 15801
Phone (814) 375-2040
123 Hospital Ave
Dubois, PA 15801
Phone (814) 371-1510
Interoperability endpoints
- jlyebernetsky@1285.direct.myezyaccess.com
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1516320000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1722988800000",
"number": "1992213318",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "123 HOSPITAL AVE",
"city": "DU BOIS",
"state": "PA",
"postal_code": "158011409",
"telephone_number": "814-371-2922"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "123 HOSPITAL AVE",
"city": "DU BOIS",
"state": "PA",
"postal_code": "158011409",
"telephone_number": "814-371-2922"
}
],
"practiceLocations": [
{
"address_1": "100 N Academy Ave",
"address_purpose": "LOCATION",
"city": "Danville",
"state": "PA",
"postal_code": "178229800",
"country_code": "US",
"telephone_number": "570-271-6211",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "YEBERNETSKY",
"first_name": "JESSICA",
"middle_name": "LYNN",
"name_prefix": "Mrs.",
"credential": "CRNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-01-19",
"last_updated": "2024-08-07",
"certification_date": "2024-08-07",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "PA",
"license": "SP017845",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "PA",
"license": "SP017845",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "jyebernetsky160727@direct.geisinger.edu",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "100 N Academy Ave",
"city": "Danville",
"state": "PA",
"country_code": "US",
"postal_code": "178229800",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Du Bois, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.