Individual provider Active NPI

Jennifer Sorrelle-Ferguson, NNP

  • Critical Care Neonatal Nurse Practitioner
  • Houston, TX
National Provider Identifier
1245600154
Registry record updated Aug 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Neonatal Nurse PractitionerTaxonomy code 363LN0005X
License
AP125598 Issued in TX
Practice address
929 Gessner Rd
Houston, TX 77024
Phone
(602) 476-8961
Fax
(623) 643-9236
NPI assigned
Oct 5, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal Intensive Care Registered Nurse 163WN0002X AP TX
Critical Care Neonatal Nurse Practitioner 363LN0005X AP125598 TX Primary

Addresses

Primary practice location

929 Gessner Rd
Houston, TX 77024

Mailing address

929 Gessner
Memorial Herman Tower 4TH Floor Neonatology
Houston, TX 77024

Other practice location 1

5555 W Thunderbird Rd
Glendale, AZ 85306-4622
Phone (954) 837-5773

Other practice location 2

6621 Fannin St
Houston, TX 77030-2399
Phone (832) 824-1000

Other identifiers 1

IdentifierTypeStateIssuer
1245600154MedicaidAZ

Other names 1

  • Jennifer Sorrelle Professional name

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
I20180924001039 TX Practitioner - Nurse Practitioner 7214288752 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APTXMDNeonatal Intensive Care Registered Nurse

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": "1444003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535068800000",
    "number": "1245600154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "929 GESSNER",
            "address_2": "MEMORIAL HERMAN TOWER 4TH FLOOR NEONATOLOGY",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "77024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "929 GESSNER RD",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "77024",
            "telephone_number": "602-476-8961",
            "fax_number": "623-643-9236"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5555 W Thunderbird Rd",
            "address_purpose": "LOCATION",
            "city": "Glendale",
            "state": "AZ",
            "postal_code": "853064622",
            "country_code": "US",
            "telephone_number": "954-837-5773",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6621 Fannin St",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770302399",
            "country_code": "US",
            "telephone_number": "832-824-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SORRELLE-FERGUSON",
        "first_name": "JENNIFER",
        "credential": "NNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-05",
        "last_updated": "2018-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WN0002X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Neonatal Intensive Care",
            "state": "TX",
            "license": "AP",
            "primary": false
        },
        {
            "code": "363LN0005X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal, Critical Care",
            "state": "TX",
            "license": "AP125598",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1245600154",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "SORRELLE",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.