MARISA JEAN JERGENSON RN, BSN, CADC
NPI 1902482300
Registered Nurse in Fort Dodge, IA

Q: What is Marisa Jergenson's NPI number?

The NPI number for Marisa Jergenson is 1902482300. It was assigned to this individual provider in the NPPES registry on March 24, 2021.

Q: What is Marisa Jergenson's specialty?

The primary specialty registered for this NPI is Registered Nurse with taxonomy code 163W00000X.

Q: When was this NPI record last updated?

The NPPES record for Marisa Jergenson was last updated on June 19, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since March 24, 2021PECOS Enrolled

211 AVENUE M W, FORT DODGE, IA 50501(515) 576-7261(515) 955-7628 Get Directions Write a Review

NPPES record last updated: June 19, 2023. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Jun 19, 2023, Mar 24, 2021 (2 updates tracked since 2021).

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About Marisa Jean Jergenson Rn, Bsn, Cadc NPPES

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

MARISA JEAN JERGENSON RN, BSN, CADC (NPI 1902482300) is an individual registered nurse in Fort Dodge, Iowa, licensed in Iowa (131852) and active in the NPI registry since March 2021. She is enrolled in Medicare PECOS and is a graduate of Other (2025).

NPPES Registry Identity

NPI1902482300

Entity TypeIndividualFemale

Primary Taxonomy163W00000X

Provider Legal NameMARISA JEAN JERGENSONCredential: RN, BSN, CADC

Location Address211 AVENUE M WFort Dodge, IA 50501-5789

Mailing Address211 Avenue M WFort Dodge, IA 50501-5789 · (515) 576-7261 · Fax (515) 955-7628

Phone(515) 576-7261

Fax(515) 955-7628

Sole ProprietorNo

Medical School CMSOtherGraduated 2025

Enumeration DateMarch 24, 2021

Last NPPES UpdateJune 19, 20232 updates tracked since enumeration

NPPES CertifiedJune 19, 2023

✔ NPI 1902482300 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyRegistered NurseNursing Service Providers

Taxonomy Code163W00000X

License✔ Licensed in IA · 131852

Definition

(1) A registered nurse is a person qualified by graduation from an accredited nursing school (depending upon schooling, a registered nurse may receive either a diploma from a hospital program, an associate degree in nursing (A.D.N.) or a Bachelor of Science degree in nursing (B.S.N.), who is licensed or certified by the state, and is practicing within the scope of that license or certification. R.N.'s assist patient in recovering and maintaining their physical or mental health. They assist physicians during treatments and examinations and administer medications. (2) A provider who is trained and educated in a formal nursing education program at an accredited school of nursing, passes a national certification examination, and is licensed by the state to practice nursing. The individual provides nursing services to patients or clients in areas such as health promotion, disease prevention, acute and chronic care and restoration and maintenance of health across the life span.

Also ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X · License 21037 (IA)

211 AVENUE M W, Fort Dodge, IA 50501

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Marisa Jean Jergenson Rn, Bsn, Cadc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID6608362454

PECOS Enrollment IDI20251231000849

Eligible to Order & Refer– Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.