Jenna Lee Jensen (NPI# 1194095570, PAC ID# 7911166731) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1194095570 |
| PAC ID by PECOS | 7911166731 |
| Professional Enrollment ID | I20120313000920 |
| Full Name | Jenna Lee Jensen |
| Organization Legal Name | LOST RIVERS MEDICAL CENTER |
| Address |
551 Highland Dr Arco ID 83213-5003 |
| Phone Number | 2085278206 |
| Gender | F |
| Graduation Year | 2011 |
| Primary Specialty | NURSE PRACTITIONER |
| Group Practice PAC ID | 7810807427 |
| Number of Group Practice Members | 6 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 131324 | LOST RIVERS MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 551 Highland Dr, Arco, ID 83213-5003 | 2085278206 | LOST RIVERS MEDICAL CENTER |
| Organization Legal Name | LOST RIVERS MEDICAL CENTER |
| Physicians | 4 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Mary B Spraktes | Nurse Practitioner | Lost Rivers Medical Center | 551 Highland Dr, Arco, ID 83213-5003 |
| Christopher A Heatherton | Family Medicine | Lost Rivers Medical Center | 551 Highland Dr, Arco, ID 83213-5003 |
| Helen M Merrill | Chiropractic | Lost Rivers Medical Center | 551 Highland Dr, Arco, ID 83213-5003 |
| Street Address |
551 HIGHLAND DR |
| City | ARCO |
| State | ID |
| Zip | 83213-5003 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Cody E Jones | Optometry | 551 Highland Dr, Arco, ID 83213-5003 | |
| Mary B Spraktes | Nurse Practitioner | Lost Rivers Medical Center | 551 Highland Dr, Arco, ID 83213-5003 |
| Christopher A Heatherton | Family Medicine | Lost Rivers Medical Center | 551 Highland Dr, Arco, ID 83213-5003 |
| Helen M Merrill | Chiropractic | Lost Rivers Medical Center | 551 Highland Dr, Arco, ID 83213-5003 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Ronald Sebreros | Clinical Social Worker | Mental Wellness Centers, Inc | 159 N Idaho St, Arco, ID 83213-4708 |
| City | ARCO |
| Zip Code | 83213 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | ARCO + NURSE PRACTITIONER |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.