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MS. JENNIFER SHINE MIDDENDORF ANP-C NPI 1720421175


NPI Information

NPI: 1720421175
Provider Name: MS. JENNIFER SHINE MIDDENDORF, ANP-C
Classification: Nurse Practitioner - 363LA2200X
Entity Type: Individual

Specialization: Adult Health

PECOS Registration: Yes

Address:
1 BRONZE POINTE BLVD STE 1A
SWANSEA, IL
ZIP 62226
Phone: (618) 233-7055
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MS. Jennifer Shine Middendorf, ANP-C is an adult health nurse practitioner in Swansea, IL with 12 years of experience. MS. Jennifer Shine Middendorf, ANP-C NPI is 1720421175. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1 BRONZE POINTE BLVD STE 1A
SWANSEA, IL
ZIP 62226-045
Phone: (618) 233-7055
Fax: (618) 233-9055

The NPI 1720421175 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Testing for presence of drug (HCPCS:80305)

The enumeration date for this NPI number is 4/15/2013 and was last updated on 7/21/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1363L00000XNurse Practitioner2013009799MISSOURINo
2363LA2200XNurse PractitionerAdult Health209010646ILLINOISYes
3163W00000XRegistered Nurse2004030088MISSOURINo
4207LP2900XAnesthesiologyPain Medicine209010646ILLINOISNo
5363L00000XNurse Practitioner209010646ILLINOISNo

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.