MRS. JENNETTE MARIE HOLLISTER (CNM) – Midwife, NPI 1164195699

MRS. JENNETTE MARIE HOLLISTER (CNM) is a healthcare provider. based in Rockford, Illinois. specializing in CERTIFIED NURSE MIDWIFE (CNM). They hold the professional credentials CNM. The NPI Number for MRS. JENNETTE MARIE HOLLISTER (CNM) is 1164195699

Main info

Female
5 Years Of Experience
Accepts Medicare Assignment
Name
MRS. JENNETTE MARIE HOLLISTER (CNM)
NPI
1164195699
Phone
(815) 490-1600
Address
1200 W STATE ST
Enumeration Date
29 July 2021
Last Update Date
29 July 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8154901600
Graduation Year
2021 (5 years ago)
PAC ID
2466818836
Group Practice PAC ID
5799682993
Professional Enrollment ID
I20230510002396
Address ID
IL611041429RO1100XBROA200
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience23
Completeness75
Years active:4State licenses:0Digital endpointsOther names

236 CERTIFIED NURSE MIDWIFE (CNM) in IL

Provider Addresses for MRS. JENNETTE MARIE HOLLISTER (CNM)

  • 1200 W STATE ST

    ROCKFORD, IL 611022112

    Phone: (815) 490-1600

    Fax: (815) 490-1881

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2023-05-10

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20230510002396ICertified Nurse Midwife (Cnm)ILTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 61102)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 5799682993View full group profile
NameSpecialtyState
Infectious DiseaseIL
Nurse PractitionerIL
Nurse PractitionerIL
Nurse PractitionerIL
Nurse PractitionerIL
Nurse PractitionerIL
Nurse PractitionerWI
Nurse PractitionerIL
Physician AssistantIL
-IL

Reviews

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Frequently asked questions

How is MRS. JENNETTE MARIE HOLLISTER (CNM) identified in CMS data?
CMS-hosted NPPES data lists MRS. JENNETTE MARIE HOLLISTER (CNM) with NPI 1164195699.
Is MRS. JENNETTE MARIE HOLLISTER (CNM) listed as active for patients and plans?
The listing shows MRS. JENNETTE MARIE HOLLISTER (CNM) as active in the NPI system.
What is MRS. JENNETTE MARIE HOLLISTER (CNM)'s primary classification?
Midwife is the headline specialty for MRS. JENNETTE MARIE HOLLISTER (CNM) here. Clinical services aligned with this taxonomy classification.
Does MRS. JENNETTE MARIE HOLLISTER (CNM) list a practice location?
Patients near Rockford, Illinois may find MRS. JENNETTE MARIE HOLLISTER (CNM) in results; validate coverage separately.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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