Jacquline A Tessen, M.D.
Individual provider Active NPI Obstetrics & Gynecology Physician · Anniston, AL
NPI 1376595082 · NPPES record last updated Oct 13, 2016
Key facts
- NPI
- 1376595082
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Obstetrics & Gynecology Physician 207V00000X
- License
- MD27217 (AL)
- Practice address
- 1010 Christine Ave
Anniston, AL 36207-5782 - Phone
- (256) 236-5631
- Fax
- (256) 624-9388
- NPI assigned
- May 17, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20060519000098 | AL | Practitioner - Obstetrics/Gynecology | 2466463898 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD27217 | AL | MD | Obstetrics & Gynecology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Anniston OBGYN Associates, P.C. | Current |
Accepting new patients | |
| Caroline a Reich MD PC | Past | Accepting new patients | |
| Allervie Health Professional Corporation | Past | Accepting new patients |
Locations
901 Leighton Ave
Ste 501
Anniston, AL 36207
Phone (256) 237-6755
Interoperability endpoints
- jacqulinetessen@annmc.allscriptsdirect.net
- https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | MD27217 | AL | Yes |
Addresses
Primary practice location
1010 Christine Ave
Anniston, AL 36207-5782
Mailing address
PO Box 2127
Anniston, AL 36202-2127
Phone (256) 236-5631
Other providers in Anniston, AL
- Timothy Bret Tabor
- Amy T Taylor
- Lafredia F. Taylor
- William Teague
- Shannon Michelle Terrell
- The Arc of Calhoun and Cleburne Counties
- The Broad Place Counseling
- The Cardiovascular Clinics, PC
- The Health Care Authority of the City of Anniston
- The Health Care Authority of the City of Anniston
All providers in Anniston, AL · Obstetrics & Gynecology Physician in Alabama
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 13, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.