Individual provider Active NPI

Herman Jenkins Jr., CRNA

  • Certified Registered Nurse Anesthetist
  • Pensacola, FL
National Provider Identifier
1386782571
Registry record updated Mar 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
9277167 Issued in FL
Practice address
6000 W Highway 98
Pensacola, FL 32512-0001
Phone
(850) 505-6762
NPI assigned
Feb 1, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 681113 CA
Certified Registered Nurse Anesthetist 367500000X 77866 IL
Certified Registered Nurse Anesthetist 367500000X 9277167 FL Primary

Addresses

Primary practice location

6000 W Highway 98
Pensacola, FL 32512-0001

Mailing address

508 Pheasant TRL
Crestview, FL 32536-5475
Phone (360) 649-5706

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110301000986 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 9133300742 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Uniformed Services Uhs Fe Hebert School of Med, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ams National LLCGroup PAC ID 3870813025, 310 clinicians

Practice addresses (Care Compare)

6002 Berryhill Rd
Milton, FL 32570-5062
Phone (850) 626-7762

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
681113CAMDRegistered Nurse
9277167FLMDCertified Registered Nurse Anesthetist
77866ILMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Ams National LLC Nurse Anesthetist, Certified Registered CurrentSince Jan 18, 2016 Accepting new patients

Locations

6002 Berryhill Rd
Milton, FL 32570
Phone (850) 474-8688

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1170288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457481600000",
    "number": "1386782571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "508 PHEASANT TRL",
            "city": "CRESTVIEW",
            "state": "FL",
            "postal_code": "325365475",
            "telephone_number": "360-649-5706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6000 W HIGHWAY 98",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325120001",
            "telephone_number": "850-505-6762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENKINS",
        "first_name": "HERMAN",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-01",
        "last_updated": "2016-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "681113",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": "77866",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "9277167",
            "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 Mar 9, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.