Individual provider Active NPI

Jeneile R Cordell, MD

  • Pediatrics Physician
  • Pensacola, FL
National Provider Identifier
1154526614
Registry record updated Apr 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ME98599 Issued in FL
Practice address
5190 Bayou Blvd Ste 7
Pensacola, FL 32503-2162
Phone
(850) 478-1100
Fax
(850) 478-4289
NPI assigned
Jun 15, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 26, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X ME98599 FL Primary

Addresses

Primary practice location

5190 Bayou Blvd Ste 7
Pensacola, FL 32503-2162

Mailing address

4205 Belfort Rd Ste 4015
Jacksonville, FL 32216-3623
Phone (904) 450-6063

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070911000232 FL Practitioner - Pediatric MedicinePractitioner - Emergency Medicine 0648363358 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Sacred Heart Health System, Inc. CurrentSince Apr 15, 2022 Accepting new patients
Sacred Heart Health System Inc CurrentSince Apr 15, 2022 Accepting new patients
Sacred Heart Health System, Inc. Current Accepting new patients
Panhandle Emergency Physicians a Div of Sacred Heart Hosp Pensacola Past Accepting new patients
Sacred Heart Health System, Inc. Past Accepting new patients

Locations

4205 Belfort Rd
Ste 4015
Jacksonville, FL 32216
Phone (904) 296-5691

5151 N 9th Ave
Pensacola, FL 32504
Phone (850) 202-4700

5192 Bayou Blvd
Pensacola, FL 32503
Phone (850) 484-5040

4501 N Davis Hwy
Ste A
Pensacola, FL 32503
Phone (850) 476-9000

1657 Trinity Dr
Pensacola, FL 32504
Phone (850) 416-2400

5190 Bayou Blvd
Ste 7
Pensacola, FL 32503
Phone (850) 478-1100

Interoperability endpoints

  • Direct secure messaging: jeneile.cordell.1@9582.direct.athenahealth.com

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1181865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650931200000",
    "number": "1154526614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4205 BELFORT RD STE 4015",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322163623",
            "telephone_number": "904-450-6063",
            "fax_number": "904-539-4091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5190 BAYOU BLVD STE 7",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325032162",
            "telephone_number": "850-478-1100",
            "fax_number": "850-478-4289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORDELL",
        "first_name": "JENEILE",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-15",
        "last_updated": "2022-04-26",
        "certification_date": "2022-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME98599",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pensacola, FL

Sources for this page

Verify at the official NPI Registry.