Paul Thomas Jennings, P.A.-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9106760 Issued in FL

Practice address

951 N Washington Ave
Titusville, FL 32796-2163

Phone

(321) 268-6111

NPI assigned

Oct 1, 2012

Last updated

Oct 1, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

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

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

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Inphynet Contracting Services LLC

  • Emergency Medicine Physician
  • Delray Beach, FL
  • NPI 1073556767
  Medicare reassignment

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

{
    "created_epoch": "1349049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349049600000",
    "number": "1457602468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "685 SCOTTY DR",
            "city": "TITUSVILLE",
            "state": "FL",
            "postal_code": "327806923",
            "telephone_number": "321-543-6115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "951 N WASHINGTON AVE",
            "city": "TITUSVILLE",
            "state": "FL",
            "postal_code": "327962163",
            "telephone_number": "321-268-6111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENNINGS",
        "first_name": "PAUL",
        "middle_name": "THOMAS",
        "name_prefix": "Mr.",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-10-01",
        "last_updated": "2012-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9106760",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• JC Quality Care Transport Service LLC
• Linda Faye Jean, RD, LDN
• Dieula Della Jeanpierre
• Alicia Jenkins
• Cornelius Jenkins
• Richard Bruce Jensen, OD
• Jennifer Jesseman, PMHNP
• Noemi Isabel Jimenez
• JL Gran Services, Inc
• Jmaxhq LLC (HealthQuest Wellness Center)

• Physician Assistant in Titusville, FL
• Providers in Titusville, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2012; 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.