Jennifer Hagan Mann, CRNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

1-100304 Issued in AL

Practice address

213 Lightwood Rd Ste 1
Deatsville, AL 36022-3800

Phone

(334) 543-4164

Fax

(334) 543-4165

NPI assigned

Aug 17, 2009

Last updated

Nov 28, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Holtville Family PracticeGroup PAC ID 5890059240, 3 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Prattville Baptist Hospital Hospital, Prattville, AL, CCN 010108

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse, Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/17295/brand/1/csg/1/fhir/r4
• Direct secure messaging: jennifer.mann.1@17295.direct.athenahealth.com

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.

• Holtville Family Practice

  • Family Medicine Physician
  • Wetumpka, AL
  • NPI 1497260889
  Medicare reassignment Care Compare group NPD
• Emergency Services of Montgomery PC

  • Emergency Medicine Physician
  • Prattville, AL
  • NPI 1528310323

  Nurse Practitioner

  Medicare reassignment NPD
• Paragon Contracting Services LLC

  • Emergency Medicine Physician
  • Birmingham, AL
  • NPI 1225071459

  Nurse Practitioner

  Medicare reassignment NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• The Health Care Authority for Baptist Health an Affiliate of Uabhs

  dba Prattville Baptist Hospital

  • General Acute Care Hospital
  • Prattville, AL
  • NPI 1942391230
  Care Compare affiliation

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

{
    "created_epoch": "1250467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669593600000",
    "number": "1063644623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "564 N MEMORIAL DR",
            "city": "PRATTVILLE",
            "state": "AL",
            "postal_code": "360672132",
            "telephone_number": "334-358-2010",
            "fax_number": "334-358-2013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "213 LIGHTWOOD RD STE 1",
            "city": "DEATSVILLE",
            "state": "AL",
            "postal_code": "360223800",
            "telephone_number": "334-543-4164",
            "fax_number": "334-543-4165"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "564 N Memorial Dr",
            "address_purpose": "LOCATION",
            "city": "Prattville",
            "state": "AL",
            "postal_code": "360672132",
            "country_code": "US",
            "telephone_number": "334-358-2010",
            "fax_number": "334-358-2013",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANN",
        "first_name": "JENNIFER",
        "middle_name": "HAGAN",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-17",
        "last_updated": "2022-11-28",
        "certification_date": "2022-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AL",
            "license": "1-100304",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "1-100304",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lisa Holmes, LPC
• Ivy Creek of Elmore, LLC (Ivy Creek Family Care of Holtville)
• Jackson Hospital and Clinic, Inc (Jackson Family Medicine Pine Level)
• Susie Bernice Jackson
• Lake Pharmacy LLC
• Jamie C Mathis, CPNP-PC
• Donald Francis McArthur, PA-C
• John Cameron McCormick
• Angela C Mims, RN CDCES
• Montgomery Drug Company Inc (Adams Drugs)

• Nurse Practitioner in Deatsville, AL
• Providers in Deatsville, AL by specialty
• Nurse Practitioner in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.