Individual provider Active NPI

Jennifer Parnell, PA-C

  • Physician Assistant
  • Oshkosh, WI
National Provider Identifier
1265832497
Registry record updated Jun 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA056833 Issued in WI
Practice address
1300 South Drive
Oshkosh, WI 54985
Phone
(920) 235-4910
NPI assigned
Aug 25, 2014
Last updated
Jun 20, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA056833 WI Primary

Addresses

Primary practice location

1300 South Drive
Oshkosh, WI 54985

Mailing address

1300 South Drive
Oshkosh, WI 54985
Phone (920) 235-4910

Other identifiers 3

IdentifierTypeStateIssuer
019525600MedicaidWI
ID867YOtherMEDICARE
Y0RK8OtherBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20150608002439 FL Practitioner - Physician Assistant 6103046354 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Harbor Medical Group LLCGroup PAC ID 5092078881, 9 clinicians

Practice addresses (Care Compare)

21298 Olean Blvd
Port Charlotte, FL 33952-6705
Phone (941) 629-1181

2500 Harbor Blvd
Port Charlotte, FL 33952-5000
Phone (941) 766-4122

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
MA056833WIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Synergy Hospital Services LLC CurrentSince Jun 6, 2026 Accepting new patients

Locations

2500 Harbor Blvd
Pt Charlotte, FL 33952
Phone (941) 766-4122

265 E Marion Ave
Unit 117A
Punta Gorda, FL 33950
Phone (941) 477-2307

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1408924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687219200000",
    "number": "1265832497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 SOUTH DRIVE",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "54985",
            "telephone_number": "920-235-4910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 SOUTH DRIVE",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "54985",
            "telephone_number": "920-235-4910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARNELL",
        "first_name": "JENNIFER",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-25",
        "last_updated": "2023-06-20",
        "certification_date": "2023-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "MA056833",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "019525600",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "ID867Y",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "Y0RK8",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oshkosh, WI

Sources for this page

Verify at the official NPI Registry.