Individual provider Active NPI

Jeniffer M Pelletier, CRNA

  • Certified Registered Nurse Anesthetist
  • Tallahassee, FL
National Provider Identifier
1093054702
Registry record updated Feb 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
ARNP9252194 Issued in FL
Practice address
2173 Centerville PL Ste a
Tallahassee, FL 32308-8303
Phone
(850) 431-5340
NPI assigned
Feb 1, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X ARNP9252194 FL Primary

Addresses

Primary practice location

2173 Centerville PL Ste a
Tallahassee, FL 32308-8303

Mailing address

1613 Harrison Pkwy
Suite 200
Sunrise, FL 33323-2896
Phone (954) 838-2371

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130326000220 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 9335384262 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Georgia-Florida Eye Centers, P.C.Group PAC ID 4385633239, shared by 3 NPIs, 10 clinicians

Practice addresses (Care Compare)

2282 E Pinetree Blvd
Thomasville, GA 31792-4807
Phone 2292266000150

Hospital & facility affiliations

  • Grady General Hospital Hospital, Cairo, GA, CCN 110121

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
ARNP9252194FLMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Fleming Island Anesthesia LLC Nurse Anesthetist, Certified Registered CurrentSince Jun 8, 2024 Accepting new patients
South Georgia Anesthesia Associates, PC Nurse Anesthetist, Certified Registered CurrentSince Sep 18, 2017 Accepting new patients
Anesthetic Solutions of Florida, LLC Nurse Anesthetist, Certified Registered CurrentSince Aug 1, 2020 Accepting new patients
Anesthesia Consultants of Savannah, PC CurrentSince Jul 16, 2018 Accepting new patients
Anesthesia Dynamics LLC Nurse Anesthetist, Certified Registered CurrentSince Jun 8, 2024 Accepting new patients
Phoebe Physician Group, Inc CurrentSince Apr 3, 2019 Accepting new patients
Sentry Anesthesia Management, LLC CurrentSince Jun 6, 2022 Accepting new patients
Bainbridge Anesthesiology, PC Nurse Anesthetist, Certified Registered CurrentSince Feb 13, 2015 Accepting new patients
Grady General Hospital CurrentSince Aug 1, 2019 Accepting new patients

Locations

665 Del Prado Blvd S
Cape Coral, FL 33990
Phone (239) 772-3636

6412 W Gulf To Lake Hwy
Crystal River, FL 34429
Phone (352) 563-0023

4571 Colonial Blvd
Ste 200
Fort Myers, FL 33966
Phone (239) 333-2050

8330 Lakewood Ranch Blvd
Lakewood Ranch, FL 34202
Phone (941) 666-8757

110 N Lecanto Hwy
Lecanto, FL 34461
Phone (352) 527-1825

9035 Sunset Dr
Ste 200
Miami, FL 33173
Phone (786) 615-6210

1670 Eagle Harbor Pkwy
Ste B
Orange Park, FL 32003
Phone (904) 541-3048

2824 Mahan Dr
Tallahassee, FL 32308
Phone (617) 981-2655

2452 Mahan Dr
Ste 102
Tallahassee, FL 32308
Phone (850) 325-6500

500 W 3rd Ave
Ste 101
Albany, GA 31701
Phone (229) 312-5802

417 W 3rd Ave
Albany, GA 31701
Phone (229) 317-2207

2002 Palmyra Rd
Ste 201
Albany, GA 31701
Phone (229) 312-5802

126 US Highway 280 W
Americus, GA 31719
Phone (229) 924-6011

151 Mayo St
Ste B
Americus, GA 31709
Phone (229) 928-2900

1500 E Shotwell St
Bainbridge, GA 39819
Phone (229) 243-6100

1155 5th St SE
Cairo, GA 39828
Phone (229) 226-3060

4700 Waters Ave
Savannah, GA 31404
Phone (912) 273-1100

915 Gordon Ave
Thomasville, GA 31792
Phone (229) 228-8575

817 Smith Ave
Thomasville, GA 31792
Phone (229) 227-0086

330 N Broad St
Ste D2
Thomasville, GA 31792
Phone (912) 228-7034

920 Cairo Rd
Thomasville, GA 31792
Phone (229) 228-8800

400 10th St E
Waconia, MN 55387

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/66097e3b-7cef-4b96-acca-38bfaae85903/

Organizations & group practices 9

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1359676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359676800000",
    "number": "1093054702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1613 HARRISON PKWY",
            "address_2": "SUITE 200",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333232896",
            "telephone_number": "954-838-2371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2173 CENTERVILLE PL STE A",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323088303",
            "telephone_number": "850-431-5340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELLETIER",
        "first_name": "JENIFFER",
        "middle_name": "M",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-01",
        "last_updated": "2013-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "ARNP9252194",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tallahassee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.