Individual provider Active NPI

Jessica Entrekin, CRNP

  • Family Nurse Practitioner
  • Huntsville, AL
National Provider Identifier
1609217876
Registry record updated Aug 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1-122465 Issued in AL
Practice address
400 Whitesport Dr SW
Suite 103
Huntsville, AL 35801-6452
Phone
(256) 880-0455
NPI assigned
Jul 16, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 19, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Nurse Practitioner 363LF0000X 1-122465 AL Primary

Addresses

Primary practice location

400 Whitesport Dr SW
Suite 103
Huntsville, AL 35801-6452

Mailing address

400 Whitesport Dr SW
Suite 103
Huntsville, AL 35801-6452
Phone (256) 880-0455

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
I20140220000353 AL Practitioner - Nurse Practitioner 8820228745 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Alabama School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Neurology Consultants of Huntsville PCGroup PAC ID 3678674082, 14 clinicians

Practice addresses (Care Compare)

2317 Memorial Pkwy SW
Suite 300
Huntsville, AL 35801-5856
Phone (256) 881-4112

Merit-based Incentive Payment System (MIPS)

Final score
88.33 of 100Reported as apm
Quality
82.81
Promoting interoperability
83.07
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1-122465ALMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Neurology Consultants of Huntsville, P.C. CurrentSince Feb 14, 2022 Accepting new patients

Locations

2317 Memorial Pkwy SW
Ste 300
Huntsville, AL 35801
Phone (256) 881-4112

Interoperability endpoints

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

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1373932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376870400000",
    "number": "1609217876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 WHITESPORT DR SW",
            "address_2": "SUITE 103",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358016452",
            "telephone_number": "256-880-0455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 WHITESPORT DR SW",
            "address_2": "SUITE 103",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358016452",
            "telephone_number": "256-880-0455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENTREKIN",
        "first_name": "JESSICA",
        "credential": "CRNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-07-16",
        "last_updated": "2013-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-122465",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntsville, AL

Sources for this page

Verify at the official NPI Registry.