Active NPI
Jamie C Jennings, CPNP-AC
- Critical Care Pediatric Nurse Practitioner
- North Port, FL
National Provider Identifier
1053788752
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Critical Care Pediatric Nurse Practitioner
- License
- APRN11006919
- Practice address
- 3149 Bobcat Village Rd
3149 Bobcat Village Rd
North Port, FL 34288 - Phone
- (727) 767-4741
- Fax
- (727) 767-2596
- NPI assigned
- Aug 28, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acute Care Nurse Practitioner | 363LA2100X | APRN.CNP.17926 | OH | |
| Critical Care Pediatric Nurse Practitioner | 363LP0222X | APRN.CNP.17926 | OH | |
| Critical Care Pediatric Nurse Practitioner | 363LP0222X | APRN11006919 | FL | Primary |
Addresses
Primary practice location
3149 Bobcat Village Rd
3149 Bobcat Village Rd
North Port, FL 34288
Mailing address
3149 Bobcat Village Rd
North Port, FL 34288
Phone (941) 266-5629
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0145456 | Medicaid | OH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| APRN11006919 | FL | MD | Critical Care Pediatric Nurse Practitioner |
| APRN.CNP.17926 | OH | MD | Critical Care Pediatric Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gold Star Pediatrics PA | Current | Accepting new patients | |
| Gold Star Pediatrics PA | Past | Accepting new patients | |
| Lima Memorial Joint Operating Company | Past | Accepting new patients |
Locations
3149 Bobcat Village Center Rd
North Port, FL 34288
Phone (941) 266-5629
3149 Bobcat Village Center Rd
Ste 14
North Port, FL 34288
Interoperability endpoints
- jjennings782479@direct.hopkinsmedicine.org
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 and National Provider Directory roles.
-
- Pediatrics Physician
- North Port, FL
- NPI 1881571578
-
- Neonatal-Perinatal Medicine Physician
- North Port, FL
- NPI 1669129342
-
- General Acute Care Hospital
- Lima, OH
- NPI 1336144732
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1440720000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1755129600000",
"number": "1053788752",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3149 BOBCAT VILLAGE RD",
"city": "NORTH PORT",
"state": "FL",
"postal_code": "34288",
"telephone_number": "941-266-5629"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3149 BOBCAT VILLAGE RD",
"address_2": "3149 BOBCAT VILLAGE RD",
"city": "NORTH PORT",
"state": "FL",
"postal_code": "34288",
"telephone_number": "727-767-4741",
"fax_number": "727-767-2596"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JENNINGS",
"first_name": "JAMIE",
"middle_name": "C",
"credential": "CPNP-AC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-08-28",
"last_updated": "2025-08-14",
"certification_date": "2025-08-11",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2100X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Acute Care",
"state": "OH",
"license": "APRN.CNP.17926",
"primary": false
},
{
"code": "363LP0222X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics, Critical Care",
"state": "OH",
"license": "APRN.CNP.17926",
"primary": false
},
{
"code": "363LP0222X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics, Critical Care",
"state": "FL",
"license": "APRN11006919",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0145456",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}
Other providers in North Port, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.