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

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: August 09, 2026.

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

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.

Other Providers at the Same Location NPPES 20

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

TIA HARTZLER IADC
Counselor (Addiction (Substance Use Disorder))
211 AVENUE M W
FORT DODGE, IA 50501
Webster County (515) 576-7261
RANDALL K MINION MD
Family Medicine (Addiction Medicine)
211 AVENUE M W
FORT DODGE, IA 50501
Webster County (515) 576-7261
JEANETTE LUCILLE MOSS CADC
Counselor (Addiction (Substance Use Disorder))
211 AVENUE M W
FORT DODGE, IA 50501
Webster County (515) 575-7261
MRS. MADISON LEE ALACHNIEWICZ CADC
Counselor (Addiction (Substance Use Disorder))
211 AVENUE M W
FORT DODGE, IA 50501
Webster County (515) 576-7261
DANIELLE BRADY
Counselor (Addiction (Substance Use Disorder))
211 AVENUE M W
FORT DODGE, IA 50501
Webster County (515) 576-7261
MICHAEL JOHN RYAN BA, CADC
Counselor (Addiction (Substance Use Disorder))
211 AVENUE M W
FORT DODGE, IA 50501
Webster County (515) 576-7261
MRS. ANDREA MARIE JONDLE-HOWARD IADC
Counselor
211 AVENUE M W
FORT DODGE, IA 50501
Webster County (515) 576-7261
CONNIE HARVEY CADC
Counselor (Addiction (Substance Use Disorder))
211 AVENUE M W
FORT DODGE, IA 50501
Webster County (515) 576-7261

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 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.

Where is Marisa Jergenson located?

Marisa Jergenson practices at 211 Avenue M W, Fort Dodge, IA 50501. The listed phone number is (515) 576-7261.

What is Marisa Jergenson's specialty?

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

Is Marisa Jergenson enrolled in Medicare?

Yes. Marisa Jergenson is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Marisa Jergenson was last updated on June 19, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years 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.