Individual provider Active NPI

Jennifer M. Hinton, P. A.

  • Emergency Medical Services (Emergency Medicine) Physician
  • Orange Park, FL
National Provider Identifier
1396794137
Registry record updated Oct 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X
License
PA9103166 Issued in FL
Practice address
1555 Kingsley Ave
Suite 503
Orange Park, FL 32073-9207
Phone
(904) 278-5088
Fax
(904) 264-4910
NPI assigned
May 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X PA9103166 FL Primary

Addresses

Primary practice location

1555 Kingsley Ave
Suite 503
Orange Park, FL 32073-9207

Mailing address

998 Browns Rd
Middleburg, FL 32068-3306
Phone (904) 555-1212

Other identifiers 3

IdentifierTypeStateIssuer
P00239935OtherFLRAILROAD MEDICARE
296833OtherFLAVMED
Y05AGOtherFLBCBS

Other names 1

  • Jennifer M. Harris Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20050523000300 FL Practitioner - Physician Assistant 3870534662 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA9103166FLMDEmergency Medical Services (Emergency Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Florida Surgeons, PA Past Accepting new patients
North Florida Surgeons, PA Past Accepting new patients
Kingsley Avenue Emergency Physicians LLC Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697414400000",
    "number": "1396794137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "998 BROWNS RD",
            "city": "MIDDLEBURG",
            "state": "FL",
            "postal_code": "320683306",
            "telephone_number": "904-555-1212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1555 KINGSLEY AVE",
            "address_2": "SUITE 503",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320739207",
            "telephone_number": "904-278-5088",
            "fax_number": "904-264-4910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HINTON",
        "first_name": "JENNIFER",
        "middle_name": "M.",
        "credential": "P. A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-09",
        "last_updated": "2023-10-16",
        "certification_date": "2023-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "FL",
            "license": "PA9103166",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00239935",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVMED",
            "identifier": "296833",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "Y05AG",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "HARRIS",
            "middle_name": "M.",
            "credential": "P.A.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Orange Park, FL

Sources for this page

Verify at the official NPI Registry.