JENNIFER ALICE BERKLEY (NPI# 1295088391) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295088391 |
| Entity Type | Individual |
| Full Name | JENNIFER ALICE BERKLEY |
| Credential | APN |
| Practice Address |
2200 Fort Jesse Rd Normal IL 61761-6286 |
| Practice Telephone | 3096616290 |
| Mailing Telephone | 3096616290 |
| Enumeration Date | 2012-10-26 |
| Last Update Date | 2017-03-29 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
209012345 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| N | 364SA2200X |
Clinical Nurse Specialist Specialization: Adult Health |
209009932 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
2200 FORT JESSE RD |
| City | NORMAL |
| State | IL |
| Zip Code | 61761-6286 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538168786 | Edward H. Kolb | Orthopaedic Surgery | 2200 Fort Jesse Rd, Suite 250, Normal, IL 61761-6286 | 2005-07-19 |
| 1104333491 | Ft. Jesse Imaging Center LLC | Radiology | 2200 Fort Jesse Rd, Normal, IL 61761-6286 | 2018-01-08 |
| 1245688209 | Lindsay Connor | Nurse Practitioner | 2200 Fort Jesse Rd, Suite 110, Normal, IL 61761-6286 | 2016-06-01 |
| 1366837676 | Emily Forney | Physical Therapist | 2200 Fort Jesse Rd, Suite 240, Normal, IL 61761-6286 | 2015-04-02 |
| 1134529555 | Traci Kissinger | Physical Therapist | 2200 Fort Jesse Rd, Suite 250, Normal, IL 61761-6286 | 2014-09-04 |
| 1811323975 | Rachel E Bauman | Dietitian, Registered | 2200 Fort Jesse Rd, Suite 250, Normal, IL 61761-6286 | 2013-09-20 |
| 1063765303 | Mallory R Hippler | Counselor | 2200 Fort Jesse Rd, Normal, IL 61761-6286 | 2012-10-24 |
| 1083962500 | Jessica Johann | Nurse Practitioner | 2200 Fort Jesse Rd, 110, Normal, IL 61761-6286 | 2012-08-15 |
| 1003163379 | Jason N Richards | Occupational Therapist | 2200 Fort Jesse Rd, Normal, IL 61761-6286 | 2012-08-06 |
| 1144597667 | Orthoworks, S.c. | Orthopaedic Surgery | 2200 Fort Jesse Rd, Suite 250, Normal, IL 61761-6286 | 2011-11-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629681796 | Brittany Nicole Mekley | Nurse Practitioner | 201 N. University, Normal, IL 61761 | 2020-08-28 |
| 1679108971 | Krystal Halliday | Occupational Therapist | 1815 N Towanda Barnes Rd, Normal, IL 61761 | 2020-03-06 |
| 1265915474 | Laine E Burek | Nurse Practitioner | 1765 Bradford Ln., Normal, IL 61761 | 2018-09-13 |
| 1801389986 | Ashley Michelle James | Specialist/Technologist | 347 S. University St, Normal, IL 61761 | 2018-06-12 |
| 1447750708 | Shelley R. Ruch | Specialist/Technologist, Other | 1604 Visa Drive, Ste 1, Normal, IL 61761 | 2018-02-13 |
| 1497275069 | Mclean County Nursing Home | Non-emergency Medical Transport (VAN) | 901 N. Main St, Normal, IL 61761 | 2017-06-23 |
| 1235673666 | Megan Threm | Registered Nurse | 900 Franklin Ave Community Health Care Clinic, Normal, IL 61761 | 2016-12-04 |
| 1437513553 | Tiesha Smith | Specialist | 1800 Rockingham Dr, Apt 1d, Normal, IL 61761 | 2016-04-06 |
| 1285031658 | New Day Recovery | Community/Behavioral Health | 402 Summit, Normal, IL 61761 | 2014-12-01 |
| 1174927701 | Alyssa Marie Bruck | Occupational Therapist | 700 N Walnut St, Normal, IL 61761 | 2014-10-10 |
| Find all providers in zip 61761 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578161865 | Abigail Hardesty | Nurse Practitioner | 201 Illinois State Univ, Normal, IL 61790-0001 | 2020-10-09 |
| 1245846989 | Susan M Carl | Nurse Practitioner | 201 North University Street, Normal, IL 61790-0001 | 2020-09-18 |
| 1629681796 | Brittany Nicole Mekley | Nurse Practitioner | 201 N. University, Normal, IL 61761 | 2020-08-28 |
| 1821645607 | Ma Benirose Mcnaught | Nurse Practitioner | 1324 Berkley Rd, Normal, IL 61761-9550 | 2019-08-26 |
| 1427538198 | Taylor Ashton Taylor | Nurse Practitioner | 1302 Franklin Ave Ste 2200, Normal, IL 61761-6500 | 2018-08-21 |
| 1972018398 | Heather Winquist | Nurse Practitioner | 1300 Franklin Ave Ste 230c, Normal, IL 61761-3709 | 2017-12-07 |
| 1619331311 | Rachael Hudgins | Nurse Practitioner | 201n University, Campus Box 2540, Normal, IL 61790-0001 | 2016-04-08 |
| 1568866598 | Molly Grant | Nurse Practitioner | 201 N University St, Normal, IL 61790-2540 | 2014-10-20 |
| 1841488855 | David L Kieser | Nurse Practitioner | 1304 Franklin Ave., Normal, IL 61761 | 2007-10-04 |
| 1750321667 | Geneva A. Petersen | Nurse Practitioner | 1302 Franklin Ave Ste 2800, Normal, IL 61761-6526 | 2006-06-08 |
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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.