Individual provider Active NPI

Jennifer Joan Pollard, APRN

  • Nurse Practitioner
  • Leesburg, FL
National Provider Identifier
1144793472
Registry record updated Jan 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN11000274 Issued in FL
Practice address
601 E Dixie Ave Ste 901
Leesburg, FL 34748-7308
Phone
(352) 728-2404
NPI assigned
Jan 9, 2019
Last updated
Jan 9, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN11000274 FL Primary

Addresses

Primary practice location

601 E Dixie Ave Ste 901
Leesburg, FL 34748-7308

Mailing address

601 E Dixie Ave Ste 901
Leesburg, FL 34748-7308
Phone (352) 728-2404

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
I20190208002895 FL Practitioner - Nurse Practitioner 5395083760 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cora Health Services IncGroup PAC ID 1759290992, shared by 21 NPIs, 1,125 clinicians
Lake ENT and FPS, PAGroup PAC ID 1759380447, 9 clinicians

Practice addresses (Care Compare)

1050 Old Camp Rd
Suite 282
The Villages, FL 32162-1762
Phone (352) 693-3378

601 E Dixie Ave
Plaza 901
Leesburg, FL 34748-5953
Phone (352) 728-2404

8768 SE 165TH Mulberry LN
Cora Physical Therapy Mulberry Lane
The Villages, FL 32162-5861
Phone (352) 329-5237

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN11000274FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lake ENT & FPS, PA CurrentSince Jan 2, 2019 Accepting new patients

Locations

601 E Dixie Ave
Ste 901
Leesburg, FL 34748
Phone (352) 728-2404

1501 N US Highway 441
Ste 1402
The Villages, FL 32159
Phone (352) 396-0350

Organizations & group practices 1

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.

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": "1546992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546992000000",
    "number": "1144793472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 E DIXIE AVE STE 901",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347487308",
            "telephone_number": "352-728-2404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 E DIXIE AVE STE 901",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347487308",
            "telephone_number": "352-728-2404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLLARD",
        "first_name": "JENNIFER",
        "middle_name": "JOAN",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-09",
        "last_updated": "2019-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN11000274",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leesburg, FL

Sources for this page

Verify at the official NPI Registry.