Janessa Tenney, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

2939 W Excursion LN
Meridian, ID 83642-5308

Phone

(208) 385-7711

NPI assigned

Feb 10, 2015

Last updated

Apr 18, 2025By the provider in NPPES

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

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Oct 1, 2021 through Oct 1, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Functional Medicine of Idaho PC

  • Family Medicine Physician
  • Boise, ID
  • NPI 1336656040
  NPD (past)
• Charles Robert Pettit MD a Medical Corporation

  • Otolaryngology/Facial Plastic Surgery Physician
  • Santa Rosa, CA
  • NPI 1316268386
  NPD (past)

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

{
    "created_epoch": "1423526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744934400000",
    "number": "1194116350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "512 W GROVE ST APT 608",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837026270",
            "telephone_number": "530-635-0505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2939 W EXCURSION LN",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836425308",
            "telephone_number": "208-385-7711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TENNEY",
        "first_name": "JANESSA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-10",
        "last_updated": "2025-04-18",
        "certification_date": "2025-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Telemental Health Link LLC (Telemental Health Link - NM)
• Sri Harsha Tella, MBBS
• Ten Mile Smiles Inc
• Ten Mile Surgery Center, LLC (Ten Mile Surgery Center)
• Aubrie Tenney
• Terrace Home Health Boise LLC (Terrace Hospice)
• Terrace Home Health Boise LLC (Terrace Home Health)
• Terrace Home Health Boise LLC (Terrace Home Care)
• Terrace Home Health Boise, LLC (Terrace Home Health)
• Stephanie Terrell, NP

• Physician Assistant in Meridian, ID
• Providers in Meridian, ID by specialty
• Physician Assistant in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2025; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.