Individual provider Active NPI

Jennifer Serpe, PNP

  • Nurse Practitioner
  • Memphis, TN
National Provider Identifier
1225706427
Registry record updated Nov 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
1146907 Issued in TX
Practice address
848 Adams Ave
Memphis, TN 38103-2816
Phone
(901) 287-5437
NPI assigned
Sep 1, 2021
Last updated
Nov 21, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 1146907 TX Primary
Pediatric Critical Care Medicine Physician 2080P0203X APN0000030125 TN

Addresses

Primary practice location

848 Adams Ave
Memphis, TN 38103-2816

Mailing address

14320 Fissore Blvd
Wimauma, FL 33598-0015
Phone (605) 376-3274

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20241127000340 TX Practitioner - Nurse Practitioner 6901294842 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APN0000030125TNMDPediatric Critical Care Medicine Physician
1146907TXMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Longhorn Emergency Medical Associates PA Nurse Practitioner CurrentSince Dec 25, 2024 Accepting new patients
Children's Urgent Care, LLC Nurse Practitioner PastSince Nov 30, 2020 Accepting new patients

Locations

919 E 32nd St
Austin, TX 78705
Phone (512) 343-2466

2400 Round Rock Ave
Round Rock, TX 78681
Phone (512) 255-6066

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1630454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732147200000",
    "number": "1225706427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14320 FISSORE BLVD",
            "city": "WIMAUMA",
            "state": "FL",
            "postal_code": "335980015",
            "telephone_number": "605-376-3274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "848 ADAMS AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381032816",
            "telephone_number": "901-287-5437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SERPE",
        "first_name": "JENNIFER",
        "credential": "PNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-01",
        "last_updated": "2024-11-21",
        "certification_date": "2024-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "1146907",
            "primary": true
        },
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "TN",
            "license": "APN0000030125",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.