Individual provider Active NPI

Jenae Camille Hennessey, MSN, APRN, FNP-BC

  • Family Nurse Practitioner
  • Mobile, AL
National Provider Identifier
1417565912
Registry record updated May 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3-001616 Issued in AL
Practice address
1700 Center St
Mobile, AL 36604-3301
Phone
(251) 415-1343
Fax
(251) 415-1353
NPI assigned
Jul 21, 2020
Last updated
May 7, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 7, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 27804 TN
Family Nurse Practitioner 363LF0000X 3-001616 AL Primary

Addresses

Primary practice location

1700 Center St
Mobile, AL 36604-3301

Mailing address

PO Box 746450
Atlanta, GA 30374-6450
Phone (866) 401-3057

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
I20241008003092 AL Practitioner - Nurse Practitioner 4587083316 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
27804TNMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Chattanooga Hamilton County Hospital Authority CurrentSince Oct 5, 2020 Accepting new patients
Chattanooga Hamilton County Hospital Authority Current Accepting new patients
USA Health Physician Billing Services LLC CurrentSince Jul 16, 2024 Accepting new patients
USA Health Physician Billing Services LLC CurrentSince Jul 16, 2024 Accepting new patients

Locations

1700 Center St
Mobile, AL 36604
Phone (251) 415-1000

75 S University Blvd
Unit 6000
Mobile, AL 36608
Phone (251) 660-5555

75 S University Blvd
Unit 6500
Mobile, AL 36608
Phone (251) 445-8282

910 Blackford St
Chattanooga, TN 37403
Phone (423) 778-4044

975 E 3rd St
Chattanooga, TN 37403
Phone (423) 266-1499

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1595289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715040000000",
    "number": "1417565912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746450",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303746450",
            "telephone_number": "866-401-3057",
            "fax_number": "318-868-6430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 CENTER ST",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366043301",
            "telephone_number": "251-415-1343",
            "fax_number": "251-415-1353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENNESSEY",
        "first_name": "JENAE",
        "middle_name": "CAMILLE",
        "name_prefix": "Mrs.",
        "credential": "MSN, APRN, FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-21",
        "last_updated": "2024-05-07",
        "certification_date": "2024-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "27804",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "3-001616",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mobile, AL

Sources for this page

Verify at the official NPI Registry.