JILL VAN THOLEN
NPI 1477955201
Nurse Practitioner in Saint John, IN

Q: What is Jill Van Tholen's NPI number?

The NPI number for Jill Van Tholen is 1477955201. It was assigned to this individual provider in the NPPES registry on September 24, 2014.

Q: What is Jill Van Tholen's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Q: Is Jill Van Tholen enrolled in Medicare?

No. Jill Van Tholen has opted out of Medicare through July 1, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

Q: When was this NPI record last updated?

The NPPES record for Jill Van Tholen was last updated on March 19, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since September 24, 2014Opted out of Medicare · through Jul 1, 2028

9495 KEILMAN ST STE 6, SAINT JOHN, IN 46373(219) 440-1232(219) 285-5687 Get Directions Write a Review

NPPES record last updated: March 19, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

On this page

About Jill Van Tholen NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JILL VAN THOLEN (NPI 1477955201) is an individual nurse practitioner in Saint John, Indiana, licensed in Indiana (71005137A) and active in the NPI registry since September 2014. She has opted out of Medicare through July 1, 2028.

NPPES Registry Identity

NPI1477955201

Entity TypeIndividualFemale

Primary Taxonomy363L00000X

Provider Legal NameJILL VAN THOLEN

Location Address9495 KEILMAN ST STE 6Saint John, IN 46373-9295

Mailing Address9495 Keilman St Ste 6Saint John, IN 46373-9295 · (219) 440-1232 · Fax (219) 285-5687

Phone(219) 440-1232

Fax(219) 285-5687

Sole ProprietorNo

Enumeration DateSeptember 24, 2014

Last NPPES UpdateMarch 19, 2025

NPPES CertifiedMarch 19, 2025

✔ NPI 1477955201 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

License✔ Licensed in IN · 71005137A

Definition

(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.

9495 KEILMAN ST STE 6, Saint John, IN 46373

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Jill Van Tholen has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from July 1, 2026 through July 1, 2028.

Opt-Out Effective DateJuly 1, 2026

Opt-Out In Effect ThroughJuly 1, 2028Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

GINA ROAK

Social Worker (Clinical)

9495 KEILMAN ST STE 6
SAINT JOHN, IN 46373

Lake County (219) 671-2128

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jill Van Tholen's NPI number?

The NPI number for Jill Van Tholen is 1477955201. It was assigned to this individual provider in the NPPES registry on September 24, 2014.

Where is Jill Van Tholen located?

Jill Van Tholen practices at 9495 Keilman St Ste 6, Saint John, IN 46373. The listed phone number is (219) 440-1232.

What is Jill Van Tholen's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Jill Van Tholen enrolled in Medicare?

No. Jill Van Tholen has opted out of Medicare through July 1, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Jill Van Tholen was last updated on March 19, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.