Jeremy J Church, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

123 Baptist Way
Pensacola, FL 32503-2254

Phone

(850) 434-4011

NPI assigned

Jun 11, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL, GA2 enrollments

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 2

Merit-based Incentive Payment System (MIPS)

Final score

97.8 of 100Reported as group

Quality

93.19

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• The Emory Clinic Inc

  • Internal Medicine Physician
  • Atlanta, GA
  • NPI 1396798229
  Medicare reassignment NPD
• Pensacola Emergency Physicians, LLC

  • Emergency Medicine Physician
  • Pensacola, FL
  • NPI 1801841473
  Medicare reassignment
• The Emory Clinic Pediatric Providers

  • Pediatric Surgery Physician
  • Decatur, GA
  • NPI 1720285653
  NPD (past)

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

{
    "created_epoch": "1181520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712793600000",
    "number": "1073716619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5665 NEW NORTHSIDE DR STE 200",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303284617",
            "telephone_number": "770-874-5400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 BAPTIST WAY",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325032254",
            "telephone_number": "850-434-4011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHURCH",
        "first_name": "JEREMY",
        "middle_name": "J",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-11",
        "last_updated": "2024-04-11",
        "certification_date": "2024-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Ki Chuang, DO
• Bandish Pravin Chudasama, DO
• Purvi Chudasama, PHARMD
• Olga Chudnovska
• Michael Chung, PHARMD
• Morgan Church, ARNP
• Hannah Ciampini, LCSW
• Michelle Elizabeth Ciapponi
• Charles Anthony Ciccone, D.O.
• Nicole T Cineas, MSW

• Physician Assistant in Pensacola, FL
• Providers in Pensacola, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2024; 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.