Individual provider Active NPI

Jenna Lea Marshall, PA

  • Physician Assistant
  • Jacksonville, FL
National Provider Identifier
1093364051
Registry record updated Sep 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
13241 Bartram Park Blvd
Jacksonville, FL 32258-5212
Phone
(904) 402-8346
NPI assigned
Sep 11, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X FL Primary

Addresses

Primary practice location

13241 Bartram Park Blvd
Jacksonville, FL 32258-5212

Mailing address

145 Cloverbank Rd
St Augustine, FL 32092-9360
Phone (352) 224-8951

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20220811001469 FL Practitioner - Physician Assistant 0042693855 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mori Bean and Brooks IncGroup PAC ID 8820077878, 966 clinicians

Practice addresses (Care Compare)

1350 13TH Ave S
Jacksonville, FL 32250-3203
Phone (904) 399-5550

14550 Old Saint Augustine Rd
Jacksonville, FL 32258-2460
Phone (904) 399-5550

2001 Kingsley Ave
Orange Park, FL 32073-5148
Phone (904) 399-5550

2115 Little Rd
Trinity, FL 34655-4410
Phone (904) 399-5550

3625 University Blvd S
Jacksonville, FL 32216-4207
Phone (904) 399-5550

4421 Catheys Club LN
Jacksonville, FL 32224-5670
Phone (904) 399-5550

800 Prudential Dr
Jacksonville, FL 32207-8202
Phone (904) 399-5550

Hospital & facility affiliations

  • Baptist Health Medical Center - Jacksonville Hospital, Jacksonville, FL, CCN 100088
  • Baptist Medical Center Beaches Hospital, Jacksonville Beach, FL, CCN 100117
  • HCA Florida Orange Park Hospital Hospital, Orange Park, FL, CCN 100226
  • Baptist Medical Center - Nassau Hospital, Fernandina Beach, FL, CCN 100140

Merit-based Incentive Payment System (MIPS)

Final score
78.06 of 100Reported as group
Quality
72.79
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Organizations & group practices 2

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 4

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": "1568160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695945600000",
    "number": "1093364051",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 CLOVERBANK RD",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320929360",
            "telephone_number": "352-224-8951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13241 BARTRAM PARK BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322585212",
            "telephone_number": "904-402-8346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSHALL",
        "first_name": "JENNA",
        "middle_name": "LEA",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-11",
        "last_updated": "2023-09-29",
        "certification_date": "2023-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.