Individual provider Active NPI

Jamie C Jennings, CPNP-AC

  • Critical Care Pediatric Nurse Practitioner
  • North Port, FL
National Provider Identifier
1053788752
Registry record updated Aug 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Pediatric Nurse PractitionerTaxonomy code 363LP0222X
License
APRN11006919 Issued in FL
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

Updated by the provider on Aug 14, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
0145456MedicaidOH

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

LicenseStateTypeSpecialty
APRN11006919FLMDCritical Care Pediatric Nurse Practitioner
APRN.CNP.17926OHMDCritical Care Pediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Gold Star Pediatrics PA CurrentSince Aug 17, 2025 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

  • Direct secure messaging: 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.

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.

Verify at the official NPI Registry.