Active NPI
Jessica Tedford, MD
- Aerospace Medicine Physician
- Pensacola, FL
National Provider Identifier
1588014765
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Aerospace Medicine Physician
- License
- 30203
- Practice address
- 340 Hulse Rd
Pensacola, FL 32508-1089 - Phone
- (850) 452-9484
- NPI assigned
- Jun 17, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Aerospace Medicine Physician | 2083A0100X | 30203 | NE | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X |
Addresses
Primary practice location
340 Hulse Rd
Pensacola, FL 32508-1089
Mailing address
601 McCain Blvd
Coronado, CA 92118
Phone (619) 545-6210
Other practice location 1
100 Brewster Blvd
Naval Hospital
Camp Lejeune, NC 28547-2538
Phone (910) 450-3138
Other practice location 2
601 McCain BLVD
Coronado, CA 92118
Phone (619) 545-6210
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30203 | NE | MD | Aerospace Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1466121600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1654473600000",
"number": "1588014765",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "601 MCCAIN BLVD",
"city": "CORONADO",
"state": "CA",
"postal_code": "92118",
"telephone_number": "619-545-6210"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "340 HULSE RD",
"city": "PENSACOLA",
"state": "FL",
"postal_code": "325081089",
"telephone_number": "850-452-9484"
}
],
"practiceLocations": [
{
"address_1": "100 Brewster Blvd",
"address_2": "Naval Hospital",
"address_purpose": "LOCATION",
"city": "Camp Lejeune",
"state": "NC",
"postal_code": "285472538",
"country_code": "US",
"telephone_number": "910-450-3138",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "601 McCain BLVD",
"address_purpose": "LOCATION",
"city": "Coronado",
"state": "CA",
"postal_code": "92118",
"country_code": "US",
"telephone_number": "619-545-6210",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "TEDFORD",
"first_name": "JESSICA",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-06-17",
"last_updated": "2022-06-06",
"certification_date": "2022-05-26",
"status": "A"
},
"taxonomies": [
{
"code": "2083A0100X",
"taxonomy_group": "",
"desc": "Preventive Medicine, Aerospace Medicine",
"state": "NE",
"license": "30203",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pensacola, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.