Active NPI
Jenifer Tummenelle
- Adult Care Home Facility
- Pensacola, FL
National Provider Identifier
1295118180
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Care Home Facility
- License
- 6906747
- Practice address
- 4780 N 9TH Ave
Pensacola, FL 32503-2466 - Phone
- (850) 530-7767
- NPI assigned
- Jul 9, 2015
- Last updated
- Jul 10, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Care Home Facility | 311ZA0620X | 6906747 | FL | Primary |
Addresses
Primary practice location
4780 N 9TH Ave
Pensacola, FL 32503-2466
Mailing address
4780 N. 9TH Ave.
Pensacola, FL 32503
Phone (850) 530-7767
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6906747 | FL | MD | Adult Care Home Facility |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1436400000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1436486400000",
"number": "1295118180",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4780 N. 9TH AVE.",
"city": "PENSACOLA",
"state": "FL",
"postal_code": "32503",
"telephone_number": "850-530-7767"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4780 N 9TH AVE",
"city": "PENSACOLA",
"state": "FL",
"postal_code": "325032466",
"telephone_number": "850-530-7767"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TUMMENELLE",
"first_name": "JENIFER",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-07-09",
"last_updated": "2015-07-10",
"status": "A"
},
"taxonomies": [
{
"code": "311ZA0620X",
"taxonomy_group": "",
"desc": "Custodial Care Facility, Adult Care Home",
"state": "FL",
"license": "6906747",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pensacola, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.