Jennifer Selene Peden, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

11029576 Issued in FL

Practice address

115 N Orange St
New Smyrna Beach, FL 32168-7027

Phone

(864) 399-5281

NPI assigned

Dec 18, 2023

Sex

Female

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1702857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705449600000",
    "number": "1497523757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "296 SW STERLING TER",
            "city": "HIGH SPRINGS",
            "state": "FL",
            "postal_code": "326431461",
            "telephone_number": "864-399-5281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 N ORANGE ST",
            "city": "NEW SMYRNA BEACH",
            "state": "FL",
            "postal_code": "321687027",
            "telephone_number": "864-399-5281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEDEN",
        "first_name": "JENNIFER",
        "middle_name": "SELENE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-18",
        "last_updated": "2024-01-17",
        "certification_date": "2024-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "11029576",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maulik Sumti Patel, MD
• Skyler Joal Pavlish-Carpenter, APRN
• PCCC of Volusia LLC
• Jami L Peace, HAS
• Timothy G Pearson, LMT
• Kyle Penland, DMD
• Miranda Kavita Persaud, PA-C
• Judy A Pfister, LMT
• William Henry Pflugfelder III, RPH
• Xuan H Phan, RPH

• Nurse Practitioner in New Smyrna Beach, FL
• Providers in New Smyrna Beach, FL by specialty
• Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.