Individual provider Active NPI

Jennifer Michele Stanfield, NP

  • Nurse Practitioner
  • Macon, GA
National Provider Identifier
1235527268
Registry record updated Nov 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN135249 Issued in GA
Practice address
250 Martin Luther King Jr Blvd
Macon, GA 31201-3490
Phone
(478) 301-4111
Fax
(478) 301-5812
NPI assigned
Dec 29, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Nurse Practitioner 363L00000X RN135249 GA Primary

Addresses

Primary practice location

250 Martin Luther King Jr Blvd
Macon, GA 31201-3490

Mailing address

250 Martin Luther King Jr Blvd
Macon, GA 31201-3490
Phone (478) 301-2362

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20180919000957 GA Practitioner - Nurse Practitioner 1557670304 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Thomas C Jones, M.D., P.C. CurrentSince May 23, 2018 Accepting new patients

Locations

265 Sheraton Blvd
Macon, GA 31210
Phone (478) 746-8626

Organizations & group practices 1

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": "1419811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606089600000",
    "number": "1235527268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 MARTIN LUTHER KING JR BLVD",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312013490",
            "telephone_number": "478-301-2362",
            "fax_number": "478-301-2272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 MARTIN LUTHER KING JR BLVD",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312013490",
            "telephone_number": "478-301-4111",
            "fax_number": "478-301-5812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANFIELD",
        "first_name": "JENNIFER",
        "middle_name": "MICHELE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-29",
        "last_updated": "2020-11-23",
        "certification_date": "2020-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN135249",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Macon, GA

Sources for this page

Verify at the official NPI Registry.