JENNIFER NICOLE BORN (NPI# 1538636642) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538636642 |
| Entity Type | Individual |
| Full Name | JENNIFER NICOLE BORN |
| Credential | NP |
| Practice Address |
210 W Mckinley Ave Decatur IL 62526-5858 |
| Mailing Address |
205 W Forsyth Rd Forsyth IL 62535-4086 |
| Practice Telephone | 2178766600 |
| Mailing Telephone | 2174137196 |
| Enumeration Date | 2018-10-26 |
| Last Update Date | 2018-10-26 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | 209-018415 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740582816 | Jennifer Born | Case Manager/Care Coordinator | 3717 Taylorsville Rd, 1st Floor, Louisville, KY 40220-1333 | 2010-11-23 |
| 1760611933 | Jennifer Born | Psychologist | 1595 Selby Ave, Suite 106, Saint Paul, MN 55104-6221 | 2009-07-09 |
| 1558498105 | Jennifer M. Born | Physician Assistant | 3505 Lake City Hwy, Warsaw, IN 46580-3942 | 2007-02-28 |
| Street Address |
210 W MCKINLEY AVE |
| City | DECATUR |
| State | IL |
| Zip Code | 62526-5858 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871580142 | Cancer Care Specialists of Central Illinois, S.c. | Radiology | 210 W Mckinley Ave, Suite 1, Decatur, IL 62526-5858 | 2005-10-03 |
| 1356874093 | Cancer Care Specialists of Central Illinois, S.c | Pharmacy | 210 W Mckinley Ave, Suite 6, Decatur, IL 62526-5858 | 2017-04-10 |
| 1720510878 | Kristin Lafollette | Pharmacist | 210 W Mckinley Ave, Suite 6, Decatur, IL 62526-5858 | 2017-03-29 |
| 1689886962 | Evelena Ontiveros | Internal Medicine | 210 W Mckinley Ave, Ste 1, Decatur, IL 62526-5858 | 2007-05-07 |
| 1689761223 | Prairie Oncology Management Services Pharmacy | Pharmacist | 210 W Mckinley Ave, Ste 1, Decatur, IL 62526-5858 | 2006-10-06 |
| 1396701009 | Sebastien Simon Kairouz | Internal Medicine | 210 W Mckinley Ave, Suite 1, Decatur, IL 62526-5858 | 2006-04-21 |
| 1326007782 | Mario R Velasco | Internal Medicine | 210 W Mckinley Ave, Suite 1, Decatur, IL 62526 | 2006-03-22 |
| 1932168309 | Perry P Guaglianone | Internal Medicine | 210 W Mckinley Ave, Suite 1, Decatur, IL 62526 | 2006-03-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083100804 | Coalition | Non-emergency Medical Transport (VAN) | 2375 N Longwood Dr, Decatur, IL 62526 | 2018-07-04 |
| 1881116820 | Bria N Howard | Nurse's Aide | 606 E Warren St. Apt 609, Decatur, IL 62526 | 2017-07-12 |
| 1437683679 | Lutheran Child and Family Services | Foster Care Agency | 2826 N. Monroe Street, Decatur, IL 62526 | 2017-04-14 |
| 1083166326 | Whitney Miller | Pharmacist | 225 East Ash Ave, Decatur, IL 62526 | 2016-11-03 |
| 1487053369 | Central Illinois Health Associates, Inc | Preferred Provider Organization | 2300 N. Edward Street, Decatur, IL 62526 | 2014-08-18 |
| 1659787893 | Stephanie Marie Kanitsch | Obstetrics & Gynecology | 544 W Pershing Rd Ste A, Decatur, IL 62526 | 2014-07-09 |
| 1497169973 | Brian Hassinger | Audiologist-Hearing Aid Fitter | 2605 N Water St Ste 101, Decatur, IL 62526 | 2014-06-12 |
| 1891041570 | Decatur 2016 LLC | Dentist | 141 Epershing Rd, Decatur, IL 62526 | 2012-07-31 |
| 1558639005 | Larry Lee Christensen | Pharmacist | 225 Ash Ave, Decatur, IL 62526 | 2011-12-12 |
| 1174821540 | Nathan Pyle | Internal Medicine | 2 Memorial Dr Ste 101, Decatur, IL 62526 | 2011-03-08 |
| Find all providers in zip 62526 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
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| 1407489479 | Marathon Health LLC | Nurse Practitioner | 152 Ipsco St, Decatur, AL 35601-7412 | 2020-02-19 |
| 1518502475 | Marissa Lynne Henderson | Nurse Practitioner | 609 Medical Center Dr Ste 2700, Decatur, TX 76234-3839 | 2019-11-14 |
| 1912463456 | Kimberly S Williams | Nurse Practitioner | 4565 Riverwood Cir, Decatur, GA 30035-2935 | 2019-02-20 |
| 1164907242 | Megan Skelley | Nurse Practitioner | 487 Winn Way Ste 202, Decatur, GA 30030-1728 | 2018-09-25 |
| 1508359969 | Rebecca A Voyles | Nurse Practitioner | 575 W Hay St, Decatur, IL 62526-4164 | 2018-06-11 |
| 1598278558 | Vera Mahou | Nurse Practitioner | 4150 Snapfinger Woods Dr Ste 120, Decatur, GA 30035-3417 | 2017-11-13 |
| 1346753738 | Alexis Renee Graven | Nurse Practitioner | 2300 N Edward St Ste 2400, Decatur, IL 62526-4163 | 2017-11-08 |
| 1508240409 | Zachary Pitts | Nurse Practitioner | 2606 Woodridge Dr, Decatur, GA 30033-4835 | 2015-07-10 |
| 1891063095 | Alexis E. Daugherty | Nurse Practitioner | 603 Church St, Decatur, GA 30030-2517 | 2011-12-02 |
| Find all providers in DECATUR | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.