Individual provider Active NPI

Jessica McClanahan, CRNP

  • Neonatal Nurse Practitioner
  • Birmingham, AL
National Provider Identifier
1083239966
Registry record updated Jul 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal Nurse PractitionerTaxonomy code 363LN0000X
License
SP022875 Issued in PA
Practice address
3690 Grandview Pkwy
Birmingham, AL 35243-3326
Phone
(205) 971-1000
NPI assigned
Jun 16, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Neonatal Nurse Practitioner 363LN0005X SP022875 PA
Critical Care Neonatal Nurse Practitioner 363LN0005X 1-198456 AL
Neonatal Nurse Practitioner 363LN0000X SP022875 PA Primary

Addresses

Primary practice location

3690 Grandview Pkwy
Birmingham, AL 35243-3326

Mailing address

23111 Downing Park Cir
MC Calla, AL 35111-3082

Other practice location 1

4800 Friendship Ave
Pittsburgh, PA 15224-1722
Phone (412) 578-5858

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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

Enrollment IDStateProvider typePAC IDDetails
I20250808002564 PA Order and Referring Only - Nurse Practitioner 1658784004

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
SP022875PAMDNeonatal Nurse Practitioner
1-198456ALMDCritical Care Neonatal Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1592265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753660800000",
    "number": "1083239966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23111 DOWNING PARK CIR",
            "city": "MC CALLA",
            "state": "AL",
            "postal_code": "351113082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3690 GRANDVIEW PKWY",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352433326",
            "telephone_number": "205-971-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4800 Friendship Ave",
            "address_purpose": "LOCATION",
            "city": "Pittsburgh",
            "state": "PA",
            "postal_code": "152241722",
            "country_code": "US",
            "telephone_number": "412-578-5858",
            "fax_number": "412-578-1529",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCCLANAHAN",
        "first_name": "JESSICA",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-16",
        "last_updated": "2025-07-28",
        "certification_date": "2025-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LN0005X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal, Critical Care",
            "state": "PA",
            "license": "SP022875",
            "primary": false
        },
        {
            "code": "363LN0005X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal, Critical Care",
            "state": "AL",
            "license": "1-198456",
            "primary": false
        },
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "PA",
            "license": "SP022875",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

Verify at the official NPI Registry.