Individual provider Active NPI

Jenna Martin

  • Family Nurse Practitioner
  • Webster, TX
National Provider Identifier
1275932287
Registry record updated Apr 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP127612 Issued in TX
Practice address
17080 Highway 3
Webster, TX 77598-4129
Phone
(281) 557-5525
NPI assigned
Aug 14, 2014
Last updated
Apr 17, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2018

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 AP07946 LA
Family Nurse Practitioner 363LF0000X AP127612 TX Primary

Addresses

Primary practice location

17080 Highway 3
Webster, TX 77598-4129

Mailing address

17080 Highway 3
Webster, TX 77598-4129

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
I20210921003248 FL Practitioner - Nurse Practitioner 1254552979 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Radial Health Southeast LLCGroup PAC ID 7113357476, 24 clinicians

Practice addresses (Care Compare)

8383 N Davis Hwy
Pensacola, FL 32514-0321
Phone (850) 494-3212

Merit-based Incentive Payment System (MIPS)

Final score
96.82 of 100Reported as group
Quality
85
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP07946LAMDFamily Nurse Practitioner
AP127612TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Radial Health Southeast LLC CurrentSince Aug 3, 2021 Accepting new patients
Duchon Chiropractic Past Accepting new patients
David a. Potts, D.C. Past Accepting new patients
Bay Oaks Physical Medicine, PLLC PastSince Feb 13, 2013 Accepting new patients

Locations

60 Memorial Medical Pkwy
Palm Coast, FL 32164
Phone (385) 586-2000

3291 E Olive Rd
Pensacola, FL 32514
Phone (850) 471-5400

7000 Cobble Crk
Pensacola, FL 32504
Phone (850) 377-5938

8325 University Pkwy
Pensacola, FL 32514
Phone (850) 324-9633

8383 N Davis Hwy
Pensacola, FL 32514
Phone (850) 494-3212

8475 University Pkwy
Pensacola, FL 32514
Phone (850) 384-4125

9310 Fowler Ave
Pensacola, FL 32534
Phone (850) 430-0600

3152 Little Rd
Trinity, FL 34655
Phone (727) 271-9156

Organizations & group practices 4

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": "1407974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523923200000",
    "number": "1275932287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17080 HIGHWAY 3",
            "city": "WEBSTER",
            "state": "TX",
            "postal_code": "775984129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17080 HIGHWAY 3",
            "city": "WEBSTER",
            "state": "TX",
            "postal_code": "775984129",
            "telephone_number": "281-557-5525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "JENNA",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-14",
        "last_updated": "2018-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "AP07946",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP127612",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Webster, TX

Sources for this page

Verify at the official NPI Registry.