Andrea S Jennings, PA-C, RD

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA284 Issued in KY

Practice address

110 2ND St
Henderson, KY 42420-3136

Phone

(270) 631-2412

NPI assigned

Mar 15, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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

{
    "created_epoch": "1521072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521072000000",
    "number": "1437652567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1305 N ELM ST",
            "city": "HENDERSON",
            "state": "KY",
            "postal_code": "424202783",
            "telephone_number": "270-631-2412",
            "fax_number": "270-631-2421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 2ND ST",
            "city": "HENDERSON",
            "state": "KY",
            "postal_code": "424203136",
            "telephone_number": "270-631-2412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENNINGS",
        "first_name": "ANDREA",
        "middle_name": "S",
        "credential": "PA-C, RD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-03-15",
        "last_updated": "2018-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "PA284",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James a Hohman MD, PSC
• Tamara James, LMFT
• Sarah Elizabeth Jankowski, OT
• Jason Samuel Chartered
• Bailey Nicole Jenkins, COTA
• Gary L Jennings, DMD
• Jackson Clay Jennings, DMD
• Jessica H. Renaker, DMD PLLC
• John B Rashidian M.D.,PSC
• John McClellan

• Physician Assistant in Henderson, KY
• Providers in Henderson, KY by specialty
• Physician Assistant in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.