Individual provider Active NPI

Jennifer Muraski, CRNP

  • Family Nurse Practitioner
  • Dothan, AL
National Provider Identifier
1467774646
Registry record updated May 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1-100696 Issued in AL
Practice address
5565 Montgomery Hwy
Dothan, AL 36303-1552
Phone
(334) 699-3733
Fax
(334) 500-3007
NPI assigned
Feb 16, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1-100696 AL Primary

Addresses

Primary practice location

5565 Montgomery Hwy
Dothan, AL 36303-1552

Mailing address

126 Clinic Dr
Dothan, AL 36303-1980
Phone (334) 793-1881

Other identifiers 4

IdentifierTypeStateIssuer
003182782CMedicaidGA
105063900MedicaidFL
242062MedicaidAL
51234979OtherALBCBS

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
I20100721000026 AL Practitioner - Nurse Practitioner 5092847475 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dothan Pediatric Clinic, P. a.Group PAC ID 0749245330, 9 clinicians

Practice addresses (Care Compare)

126 Clinic Dr
Dothan, AL 36303-1980
Phone (334) 791-1881

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dothan Pediatric Clinic, P. a. Family CurrentSince Nov 12, 2019 Accepting new patients

Locations

4370 W Main St
Dothan, AL 36305
Phone (256) 332-1611

126 Clinic Dr
Dothan, AL 36303
Phone (334) 791-1881

5565 Montgomery Hwy
Dothan, AL 36303
Phone (334) 699-3733

526 Boll Weevil Cir
Enterprise, AL 36330
Phone (334) 308-1166

323 E Barbour St
Eufaula, AL 36027
Phone (334) 619-0940

2125 W Roy Parker Rd
Ozark, AL 36360
Phone (334) 445-7337

Interoperability endpoints

  • Direct secure messaging: jennifermuraski@dpc.allscriptsdirect.net

Organizations & group practices 1

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": "1266278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589500800000",
    "number": "1467774646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "126 CLINIC DR",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363031980",
            "telephone_number": "334-793-1881",
            "fax_number": "334-340-5918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5565 MONTGOMERY HWY",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363031552",
            "telephone_number": "334-699-3733",
            "fax_number": "334-500-3007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MURASKI",
        "first_name": "JENNIFER",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-02-16",
        "last_updated": "2020-05-15",
        "certification_date": "2020-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-100696",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003182782C",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "105063900",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "242062",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "51234979",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dothan, AL

Sources for this page

Verify at the official NPI Registry.