JENNIFER NICOLE BORN (NP) – Nurse Practitioner, NPI 1538636642

JENNIFER NICOLE BORN (NP) is a healthcare provider. based in Forsyth, Illinois. specializing in NURSE PRACTITIONER. They hold the professional credentials NP. They hold a License No. 209-018415 (IL). The NPI Number for JENNIFER NICOLE BORN (NP) is 1538636642

Main info

Female
8 Years Of Experience
Accepts Medicare Assignment
Name
JENNIFER NICOLE BORN (NP)
NPI
1538636642
Phone
(217) 413-7196
Address
205 W FORSYTH RD
Enumeration Date
26 October 2018
Last Update Date
26 October 2018

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2178558808
Graduation Year
2018 (8 years ago)
PAC ID
5799029856
Group Practice PAC ID
1951769843
Professional Enrollment ID
I20181130001956
Address ID
IL624012027EF1105XAVEX500
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness75
Years active:7State licenses:1Digital endpointsOther names

11,632 NURSE PRACTITIONER in IL

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Provider Addresses for JENNIFER NICOLE BORN (NP)

  • 205, West Forsyth Road, Forsyth, Macon County, Illinois, 62535, United States

    FORSYTH, IL 625354086

    Phone: (217) 413-7196

    Type: Mailing

  • 210, West McKinley Avenue, Decatur, Macon County, Illinois, 62526, United States

    DECATUR, IL 625265858

    Phone: (217) 876-6600

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 4 Open Payments records for all available years, with a total value of $217.

Total Amount is formed as General ($217) + Research ($0) + Ownership ($0) = $217.

Last reported payment date: 2023-09-21 • Largest payer in this snapshot: VIVUS LLC ($125).

Total Amount

$217

General + Research + Ownership

Payments

4

Total payment records

General Amount

$217

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-09-21

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2018-11-30

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
I20181130001956INurse PractitionerILTBD

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 62535)

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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: 1951769843View full group profile
NameSpecialtyState
Family PracticeIL

Reviews

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Frequently asked questions

What federal number belongs to JENNIFER NICOLE BORN (NP)?
The federal identifier for JENNIFER NICOLE BORN (NP) is NPI 1538636642.
Is JENNIFER NICOLE BORN (NP)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
What does JENNIFER NICOLE BORN (NP) treat or focus on?
Patients typically see JENNIFER NICOLE BORN (NP) under the specialty Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What location shows for JENNIFER NICOLE BORN (NP)?
We surface Forsyth, Illinois for JENNIFER NICOLE BORN (NP) based on available NPPES addresses.
What if Forsyth, Illinois seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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