Individual provider Active NPI

Jennifer L McNease, CRNP

  • Pediatric Nurse Practitioner
  • Millry, AL
National Provider Identifier
1568618262
Registry record updated Mar 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
1-096789 Issued in AL
Practice address
73 Long Street
Millry, AL 36558
Phone
(251) 846-3233
Fax
(251) 846-3224
NPI assigned
Aug 13, 2008
Last updated
Mar 28, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 1-096789 AL Primary

Addresses

Primary practice location

73 Long Street
Millry, AL 36558

Mailing address

PO Box 465
Millry, AL 36558-0465
Phone (251) 846-3233

Other identifiers 5

IdentifierTypeStateIssuer
03521065MedicaidMS
008450553MedicaidMS
51593390OtherALBCBS - 1707 CENTER ST
137329MedicaidAL
137616MedicaidAL

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
I20080924000025 AL Practitioner - Nurse Practitioner 0749357333 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
1-096789ALMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Grand Bay Medical Center, Inc. Past Accepting new patients
USA Health Community Providers LLC PastSince Dec 22, 2025 Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IBCGBA/Endpoint/IBCGBA

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1218585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743120000000",
    "number": "1568618262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 465",
            "city": "MILLRY",
            "state": "AL",
            "postal_code": "365580465",
            "telephone_number": "251-846-3233",
            "fax_number": "251-846-3224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "73 LONG STREET",
            "city": "MILLRY",
            "state": "AL",
            "postal_code": "36558",
            "telephone_number": "251-846-3233",
            "fax_number": "251-846-3224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCNEASE",
        "first_name": "JENNIFER",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-13",
        "last_updated": "2025-03-28",
        "certification_date": "2025-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "AL",
            "license": "1-096789",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03521065",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008450553",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS - 1707 CENTER ST",
            "identifier": "51593390",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "137329",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "137616",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Millry, AL

Sources for this page

Verify at the official NPI Registry.