Individual provider Active NPI

Jessica Lynne Jennings, MD

  • Pediatrics Physician
  • Tampa, FL
National Provider Identifier
1023245982
Registry record updated May 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ME122346 Issued in FL
Practice address
302 W Fletcher Ave
Tampa, FL 33612-3415
Phone
(813) 397-5305
Fax
(813) 549-7855
NPI assigned
Jun 18, 2009
Last updated
May 14, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X ME122346 FL Primary

Addresses

Primary practice location

302 W Fletcher Ave
Tampa, FL 33612-3415

Mailing address

PO Box 82969
Tampa, FL 33682-2969
Phone (813) 866-0930

Other names 1

  • Jessica Lynne Davis Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181108000331 FL Practitioner - Pediatric Medicine 4486947223 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME122346FLMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tampa Family Health Centers Inc Current Accepting new patients
Tampa Family Health Centers, Inc CurrentSince Jun 17, 2018 Accepting new patients
Tampa Family Health Centers, Inc CurrentSince Jun 17, 2018 Accepting new patients

Locations

12085 W Hillsborough Ave
Tampa, FL 33635
Phone (813) 852-5270

302 W Fletcher Ave
Tampa, FL 33612

3901 S West Shore Blvd
Tampa, FL 33611
Phone (813) 712-1940

4422 E Columbus Dr
Tampa, FL 33605
Phone (813) 384-4000

4620 N 22nd St
Tampa, FL 33610
Phone (813) 272-6240

5611 Sheldon Rd
Tampa, FL 33615
Phone (813) 397-5320

6216 E Sligh Ave
Tampa, FL 33617
Phone (813) 549-8060

7608 Causeway Blvd
Tampa, FL 33619
Phone (813) 405-3710

7814 N Dale Mabry Hwy
Tampa, FL 33614
Phone (813) 405-3939

8108 N Nebraska Ave
Tampa, FL 33604
Phone (813) 712-1930

8213 W Waters Ave
Tampa, FL 33615
Phone (813) 490-5420

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1245283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431561600000",
    "number": "1023245982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 82969",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336822969",
            "telephone_number": "813-866-0930",
            "fax_number": "813-866-0929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 W FLETCHER AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336123415",
            "telephone_number": "813-397-5305",
            "fax_number": "813-549-7855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENNINGS",
        "first_name": "JESSICA",
        "middle_name": "LYNNE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-18",
        "last_updated": "2015-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME122346",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "DAVIS",
            "middle_name": "LYNNE",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.