Destiny Laine Jefferson

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

11007965 Issued in FL

Practice address

2721 Creeks Edge LN
Navarre, FL 32566-8666

Phone

(228) 282-3236

NPI assigned

Aug 29, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Bothwell Regional Health Center

  • General Acute Care Hospital
  • Sedalia, MO
  • NPI 1235102690
  Medicare reassignment NPD
• Bothwell Regional Health Center

  • Rural Health Clinic/Center
  • Cole Camp, MO
  • NPI 1497705313
  NPD
• Bothwell Regional Health Center

  • General Practice Physician
  • Sedalia, MO
  • NPI 1508239781
  NPD

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

{
    "created_epoch": "1598659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598659200000",
    "number": "1184237000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2721 CREEKS EDGE LN",
            "city": "NAVARRE",
            "state": "FL",
            "postal_code": "325668666",
            "telephone_number": "228-282-3236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2721 CREEKS EDGE LN",
            "city": "NAVARRE",
            "state": "FL",
            "postal_code": "325668666",
            "telephone_number": "228-282-3236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEFFERSON",
        "first_name": "DESTINY",
        "middle_name": "LAINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-29",
        "last_updated": "2020-08-29",
        "certification_date": "2020-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11007965",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maranda Irvin, FNP-C
• Jayla Allison Jackson, PHARMD
• Joanne Jacobs, LCSW
• Jill Carol Jacques
• Sarah James, LMHC
• Jennifer Jernigan Counseling Inc
• William Joseph Jette
• Janalea Michael Jewell
• Cristine Johnson, DPT
• Jayme Wells Johnson, LCSW

• Family Nurse Practitioner in Navarre, FL
• Providers in Navarre, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.