Jacqueline Underwood, NP

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

1-106108 Issued in AL

Practice address

39 Ashwood Rd
Butler, AL 36904-3690

Phone

(205) 459-3934

NPI assigned

Oct 2, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Mobile Picc Specialists

  • Nursing Facility/Intermediate Care Facility
  • Butler, AL
  • NPI 1568863785
  NPD (past)

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

{
    "created_epoch": "1538438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581465600000",
    "number": "1578048922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39 ASHWOOD RD",
            "city": "BUTLER",
            "state": "AL",
            "postal_code": "369042860",
            "telephone_number": "205-459-3934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39 ASHWOOD RD",
            "city": "BUTLER",
            "state": "AL",
            "postal_code": "369043690",
            "telephone_number": "205-459-3934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UNDERWOOD",
        "first_name": "JACQUELINE",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-02",
        "last_updated": "2020-02-12",
        "certification_date": "2020-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MS",
            "license": "903426",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "AZ",
            "license": "232595",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "AL",
            "license": "1-106108",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• State of Alabama Department of Public Health
• State of Alabama Department of Public Health
• Leanne Lott Tew, CRNP
• The Eye Site, P.C.
• Timberland Health and Rehabilitation Center LLC
• Julie Walker Utsey, DMD
• W Britt Morris, DMD PC
• Warm Embrace Homecare LLC
• Candace H Webb, RPH
• Jimmy Cleveland White, D.M.D.

• Acute Care Nurse Practitioner in Butler, AL
• Providers in Butler, AL by specialty
• Acute Care Nurse Practitioner in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2020; 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.