Individual provider Active NPI

Jennifer Hope Baggenstoss, PA-C

  • Physician Assistant
  • Huntsville, AL
National Provider Identifier
1487689253
Registry record updated Jun 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA 606 Issued in AL
Practice address
2780 Bob Wallace Ave SW
Huntsville, AL 35805-4104
Phone
(256) 533-4626
Fax
(256) 533-4710
NPI assigned
Jul 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA 606 AL Primary

Addresses

Primary practice location

2780 Bob Wallace Ave SW
Huntsville, AL 35805-4104

Mailing address

2780 Bob Wallace Ave SW
Huntsville, AL 35805-4104
Phone (256) 533-4626

Other identifiers 1

IdentifierTypeStateIssuer
PA 606OtherALPA LICENSE

Other names 1

  • Jennifer Hope Boyd Former name

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
I20090707000304 AL Practitioner - Physician Assistant 0547346884 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nephrology Consultants LLCGroup PAC ID 5092603472, 17 clinicians

Practice addresses (Care Compare)

2780 Bob Wallace Ave
Hunstville, AL 35805-4104
Phone (256) 533-4626

2780 Bob Wallace Ave SW
Huntsville, AL 35805-4104

Hospital & facility affiliations

  • Huntsville Hospital Hospital, Huntsville, AL, CCN 010039

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA 606ALMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Health Care Authority for Baptist Health, an Affiliate of Uabhs Past Accepting new patients

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687392000000",
    "number": "1487689253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2780 BOB WALLACE AVE SW",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358054104",
            "telephone_number": "256-533-4626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2780 BOB WALLACE AVE SW",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358054104",
            "telephone_number": "256-533-4626",
            "fax_number": "256-533-4710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAGGENSTOSS",
        "first_name": "JENNIFER",
        "middle_name": "HOPE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-11",
        "last_updated": "2023-06-22",
        "certification_date": "2023-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AL",
            "license": "PA 606",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA LICENSE",
            "identifier": "PA 606",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "BOYD",
            "middle_name": "HOPE",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Huntsville, AL

Sources for this page

Verify at the official NPI Registry.