Individual provider Active NPI

Jessica Lucas Gonzalez, MSN, CRNP, FNP-C

  • Family Nurse Practitioner
  • Crossville, AL
National Provider Identifier
1225724669
Registry record updated May 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1-180962 Issued in AL
Practice address
15239 Al Highway 68
Crossville, AL 35962-3481
Phone
(256) 925-0012
Fax
(256) 925-0016
NPI assigned
Apr 17, 2023
Last updated
May 30, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 30, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1-180962 AL Primary
Registered Nurse 163W00000X 1-180962 AL

Addresses

Primary practice location

15239 Al Highway 68
Crossville, AL 35962-3481

Mailing address

408 Martling Rd
Albertville, AL 35951-7208
Phone (256) 585-5942

Other practice location 1

408 Martling Rd
Albertville, AL 35951-7208
Phone (256) 585-5942

Other names 1

  • Jessica Lucas Altamirano Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20251105001197 AL Practitioner - Nurse Practitioner 3779073192 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

15239 Al Hwy 68
Crossville, AL 35962-3481

PO Box
Suite 1539
Walker, LA 70785

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
1-180962ALMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Asset Group, LLC Single Specialty CurrentSince Aug 28, 2025 Accepting new patients
Medical Asset Group, LLC Single Specialty CurrentSince Aug 28, 2025 Accepting new patients

Locations

3442 US Highway 431
Albertville, AL 35950
Phone (256) 593-1234

15239 AL Highway 68
Crossville, AL 35962
Phone (256) 528-7173

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": "1681689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748563200000",
    "number": "1225724669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "408 MARTLING RD",
            "city": "ALBERTVILLE",
            "state": "AL",
            "postal_code": "359517208",
            "telephone_number": "256-585-5942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15239 AL HIGHWAY 68",
            "city": "CROSSVILLE",
            "state": "AL",
            "postal_code": "359623481",
            "telephone_number": "256-925-0012",
            "fax_number": "256-925-0016"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "408 Martling Rd",
            "address_purpose": "LOCATION",
            "city": "Albertville",
            "state": "AL",
            "postal_code": "359517208",
            "country_code": "US",
            "telephone_number": "256-585-5942",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "JESSICA",
        "middle_name": "LUCAS",
        "credential": "MSN, CRNP, FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-04-17",
        "last_updated": "2025-05-30",
        "certification_date": "2025-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-180962",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AL",
            "license": "1-180962",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "ALTAMIRANO",
            "middle_name": "LUCAS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Crossville, AL

Sources for this page

Verify at the official NPI Registry.