Individual provider Active NPI

Jodie Shedd, CRNP

  • Family Nurse Practitioner
  • Montgomery, AL
National Provider Identifier
1346619368
Registry record updated Sep 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1-125176 Issued in AL
Practice address
1801 Pine St
Suite 302
Montgomery, AL 36106-0165
Phone
(334) 262-7444
NPI assigned
Sep 21, 2015
Last updated
Sep 21, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1-125176 AL Primary

Addresses

Primary practice location

1801 Pine St
Suite 302
Montgomery, AL 36106-0165

Mailing address

1801 Pine St
Suite 301
Montgomery, AL 36106-0165
Phone (334) 262-7444

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20151207001225 AL Practitioner - Nurse Practitioner 9436459930 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jackson Hospital and Clinic, IncGroup PAC ID 0547254153, 119 clinicians

Practice addresses (Care Compare)

2175 US Hwy 31 N
Deatsville, AL 36022-2714
Phone (334) 293-8736

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1-125176ALMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Jackson Hospital and Clinic, Inc. Current Accepting new patients
Jackson Hospital & Clinic, Inc. CurrentSince Jul 29, 2018 Accepting new patients
Jackson Hospital and Clinic Inc CurrentSince Jul 29, 2018 Accepting new patients
Jackson Hospital & Clinic, Inc. Past Accepting new patients

Locations

2175 US Highway 31 N
Deatsville, AL 36022
Phone (331) 568-2120

1722 Pine St
Ste 503
Montgomery, AL 36106
Phone (334) 240-2337

1722 Pine St
Ste 804
Montgomery, AL 36106
Phone (334) 834-7221

1725 Pine St
Montgomery, AL 36106
Phone (334) 293-8000

1758 Park Pl
Ste 300
Montgomery, AL 36106
Phone (334) 274-1204

1801 Pine St
Ste 301
Montgomery, AL 36106
Phone (334) 265-5577

1801 Pine St
Ste 302
Montgomery, AL 36106
Phone (334) 262-7444

Interoperability endpoints

  • Direct secure messaging: jodie.shedd.1@9186.direct.athenahealth.com

Organizations & group practices 5

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": "1442793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442793600000",
    "number": "1346619368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 PINE ST",
            "address_2": "SUITE 301",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361060165",
            "telephone_number": "334-262-7444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 PINE ST",
            "address_2": "SUITE 302",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361060165",
            "telephone_number": "334-262-7444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEDD",
        "first_name": "JODIE",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-21",
        "last_updated": "2015-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-125176",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montgomery, AL

Sources for this page

Verify at the official NPI Registry.