Jenna Lane Everett, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

Practice address

320 N Main
Lockney, TX 79241

Phone

(806) 652-3373

Fax

(806) 652-2417

NPI assigned

Oct 25, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

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

Credentials

Physician Assistant

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

{
    "created_epoch": "1477353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530144000000",
    "number": "1508318528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 37",
            "city": "LOCKNEY",
            "state": "TX",
            "postal_code": "792410037",
            "telephone_number": "806-652-3373",
            "fax_number": "806-652-2417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 N MAIN",
            "city": "LOCKNEY",
            "state": "TX",
            "postal_code": "79241",
            "telephone_number": "806-652-3373",
            "fax_number": "806-652-2417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVERETT",
        "first_name": "JENNA",
        "middle_name": "LANE",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-10-25",
        "last_updated": "2018-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "PA10940",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John Benjamin Benacci, MD
• Childress County Hospital District
• City of Lockney
• Danny Lynn Clark, R.PH.
• Krystal Lynn Delgado, , PT, DT, MAT
• Rosa Gonzales, RMT
• Hospice Hands of West Texas Inc.
• Hospice Hands of West Texas, Inc.
• Ken Jackson, P.A.
• Jeremy N Johnson, DO

• Medical Physician Assistant in Lockney, TX
• Providers in Lockney, TX by specialty
• Medical Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2018; 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.