Jenny Lynn Vincelette

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95023328 Issued in CA

Practice address

222 N Pacific Coast Hwy Ste 1420
El Segundo, CA 90245-5648

Phone

(877) 878-3289

NPI assigned

Mar 29, 2023

Last updated

Mar 29, 2023By the provider in NPPES

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

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Robert Marriott Medical Corp

  dba Advantage Wound Care

  • Surgery Physician
  • El Segundo, CA
  • NPI 1083883938
  NPD

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

{
    "created_epoch": "1680048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680048000000",
    "number": "1598469892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "553 27TH AVE APT 103",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941212853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 N PACIFIC COAST HWY STE 1420",
            "city": "EL SEGUNDO",
            "state": "CA",
            "postal_code": "902455648",
            "telephone_number": "877-878-3289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VINCELETTE",
        "first_name": "JENNY",
        "middle_name": "LYNN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-29",
        "last_updated": "2023-03-29",
        "certification_date": "2023-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95023328",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jesus Villasenor
• Gabriella Villegas
• Stephanie Villegas
• Nicholas Villongco
• Stephannia Vinasco
• Vincent Marcel Chiropractic Corp (Body Doc Healing Center)
• Christ Marie Vincent
• Roxana Viramontes
• Jamilya Viravong
• Aryana N. Viruet

• Family Nurse Practitioner in El Segundo, CA
• Providers in El Segundo, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2023; 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.