Individual provider Active NPI

Jennifer Leigh Masone

  • Family Nurse Practitioner
  • Crestview, FL
National Provider Identifier
1609651884
Registry record updated Aug 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11026023 Issued in FL
Practice address
1038 Limpkin St
Crestview, FL 32539-6758
Phone
(978) 790-1104
NPI assigned
Aug 28, 2023
Last updated
Aug 28, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 11026023 FL Primary

Addresses

Primary practice location

1038 Limpkin St
Crestview, FL 32539-6758

Mailing address

1038 Limpkin St
Crestview, FL 32539-6758
Phone (978) 790-1104

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20250225002711 FL Practitioner - Nurse Practitioner 0648790345 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11026023FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pophealthcare, LLC Family CurrentSince Dec 23, 2024 Accepting new patients
Pophealthcare, LLC CurrentSince Dec 23, 2024 Accepting new patients

Locations

10739 Deerwood Park Blvd
Ste 200
Jacksonville, FL 32256
Phone (615) 721-7024

113 Seaboard Ln
Ste 200B
Franklin, TN 37067
Phone (615) 721-7020

Interoperability endpoints

  • Direct secure messaging: jennifer.masone.1@29290.direct.athenahealth.com

Organizations & group practices 2

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": "1693180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693180800000",
    "number": "1609651884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1038 LIMPKIN ST",
            "city": "CRESTVIEW",
            "state": "FL",
            "postal_code": "325396758",
            "telephone_number": "978-790-1104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1038 LIMPKIN ST",
            "city": "CRESTVIEW",
            "state": "FL",
            "postal_code": "325396758",
            "telephone_number": "978-790-1104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASONE",
        "first_name": "JENNIFER",
        "middle_name": "LEIGH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-28",
        "last_updated": "2023-08-28",
        "certification_date": "2023-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11026023",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crestview, FL

Sources for this page

Verify at the official NPI Registry.