Jenna Lee Tobin, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

24668 Issued in SC

Practice address

100 Shadowmoss Pkwy
Charleston, SC 29414-6845

Phone

(610) 761-7768

NPI assigned

Feb 9, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in SC, CT2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Connecticut Children's Specialty Group, Inc.

  • Pediatrics Physician
  • Hartford, CT
  • NPI 1669448882
  Medicare reassignment NPD
• First Choice Health Centers, Inc.

  • Federally Qualified Health Center (FQHC)
  • East Hartford, CT
  • NPI 1215923131
  Medicare reassignment NPD
• Signify Health Medical Associates, PLLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1750845863

  SC

  Medicare reassignment NPD
• Connecticut Children's Specialty Group, Inc.

  • Ophthalmology Physician
  • Glastonbury, CT
  • NPI 1568056984
  NPD
• First Choice Health Centers, Inc.

  • Federally Qualified Health Center (FQHC)
  • East Hartford, CT
  • NPI 1215518733
  NPD

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

{
    "created_epoch": "1612828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698883200000",
    "number": "1437741535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 SHADOWMOSS PKWY",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294146845",
            "telephone_number": "610-761-7768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 SHADOWMOSS PKWY",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294146845",
            "telephone_number": "610-761-7768"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "505 Farmington Ave Ste 210",
            "address_purpose": "LOCATION",
            "city": "Farmington",
            "state": "CT",
            "postal_code": "060321901",
            "country_code": "US",
            "telephone_number": "860-837-7500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TOBIN",
        "first_name": "JENNA",
        "middle_name": "LEE",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-09",
        "last_updated": "2023-11-02",
        "certification_date": "2023-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "10764",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "24668",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Madison Tluczek, MD
• Talia Toback, LISW-CP
• Jessica Tobias, RN
• Catherine Dawson Tobin, MD
• David P Tobin, CRNA
• Sarah Tobin, D.O.
• Gwendolyn Todd-Houston, MD
• Chandler Berry Todd, MD
• Emerald Michelle Todd, PA-C
• Jasmine A Todd

• Family Nurse Practitioner in Charleston, SC
• Providers in Charleston, SC by specialty
• Family Nurse Practitioner in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.