Individual provider Active NPI

Tammy Leanne Ray Jernigan, ARNP

  • Family Nurse Practitioner
  • Pensacola, FL
National Provider Identifier
1497070585
Registry record updated Feb 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1563722 Issued in FL
Practice address
4501 N Davis Hwy Ste C
Pensacola, FL 32503-2724
Phone
(850) 416-4960
Fax
(850) 416-4961
NPI assigned
Mar 31, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2018

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 1563722 FL Primary

Addresses

Primary practice location

4501 N Davis Hwy Ste C
Pensacola, FL 32503-2724

Mailing address

2340 Bayou Blvd
Pensacola, FL 32503-5008
Phone (850) 512-8816

Other identifiers 1

IdentifierTypeStateIssuer
0026279-00MedicaidFL

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20100929000592 FL Practitioner - Nurse Practitioner 5799801536 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sacred Heart Health System IncGroup PAC ID 3779491386, 373 clinicians

Practice addresses (Care Compare)

1549 Airport Blvd
Suite 200
Pensacola, FL 32504-8633
Phone (850) 416-7838

Hospital & facility affiliations

  • Adoration Home Health Home health agency, Pensacola, FL, CCN 108168
  • Centerwell Home Health Home health agency, Pensacola, FL, CCN 107792
  • Sacred Heart Hospital Hospital, Pensacola, FL, CCN 100025
  • Baptist Hospital Hospital, Pensacola, FL, CCN 100093
  • Gulf Breeze Hospital Hospital, Gulf Breeze, FL, CCN 100266
  • Santa Rosa Medical Center Hospital, Milton, FL, CCN 100124

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1563722FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sacred Heart Health System Inc CurrentSince Feb 1, 2015 Accepting new patients
Sacred Heart Health System, Inc. Current Accepting new patients
Sacred Heart Health System, Inc. CurrentSince Feb 1, 2015 Accepting new patients
Baptist Physician Enterprise LLC Past Accepting new patients

Locations

4501 N Davis Hwy
Ste C
Pensacola, FL 32503
Phone (850) 202-1390

4501 N Davis Hwy
Ste A
Pensacola, FL 32503
Phone (850) 476-9000

1549 Airport Blvd
Ste 200
Pensacola, FL 32504
Phone (850) 416-4960

Interoperability endpoints

  • Direct secure messaging: tammy.jernigan.1@9582.direct.athenahealth.com

Organizations & group practices 4

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 6

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": "1269993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517875200000",
    "number": "1497070585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2340 BAYOU BLVD",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325035008",
            "telephone_number": "850-512-8816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4501 N DAVIS HWY STE C",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325032724",
            "telephone_number": "850-416-4960",
            "fax_number": "850-416-4961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JERNIGAN",
        "first_name": "TAMMY",
        "middle_name": "LEANNE RAY",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-31",
        "last_updated": "2018-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "1563722",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0026279-00",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pensacola, FL

Sources for this page

Verify at the official NPI Registry.