Active NPI
Jennifer Moody, ARNP
- Nurse Practitioner
- Port St Lucie, FL
National Provider Identifier
1356777650
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- ARNP9241652
- Practice address
- 10080 SW Innovation Way Ste 201
Port St Lucie, FL 34987-2129 - Phone
- (772) 344-3811
- Fax
- (772) 344-3890
- NPI assigned
- Sep 18, 2013
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | ARNP9241652 | FL | Primary |
Addresses
Primary practice location
10080 SW Innovation Way Ste 201
Port St Lucie, FL 34987-2129
Mailing address
PO Box 417
Stuart, FL 34995-0417
Phone (772) 223-5665
Other practice location 1
1651 SE Tiffany Ave
Ste 102
Port St Lucie, FL 34952-7564
Phone (772) 398-1824
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | jmoody7857@direct.martinhealth.org |
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1379462400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1602201600000",
"number": "1356777650",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 417",
"city": "STUART",
"state": "FL",
"postal_code": "349950417",
"telephone_number": "772-223-5665",
"fax_number": "772-223-5646"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10080 SW INNOVATION WAY STE 201",
"city": "PORT ST LUCIE",
"state": "FL",
"postal_code": "349872129",
"telephone_number": "772-344-3811",
"fax_number": "772-344-3890"
}
],
"practiceLocations": [
{
"address_1": "1651 SE Tiffany Ave",
"address_2": "STE 102",
"address_purpose": "LOCATION",
"city": "Port St Lucie",
"state": "FL",
"postal_code": "349527564",
"country_code": "US",
"telephone_number": "772-398-1824",
"fax_number": "772-335-2422",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MOODY",
"first_name": "JENNIFER",
"credential": "ARNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-09-18",
"last_updated": "2020-10-09",
"certification_date": "2020-10-09",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "FL",
"license": "ARNP9241652",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "jmoody7857@direct.martinhealth.org",
"affiliation": "N",
"address_1": "10080 SW Innovation Way Ste 201",
"city": "Port St Lucie",
"state": "FL",
"country_code": "US",
"postal_code": "349872129",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Port St Lucie, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.