Individual provider Active NPI

Jennifer Serafin, APRN

  • Family Nurse Practitioner
  • Amherst, NH
National Provider Identifier
1619442092
Registry record updated Jun 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
045164-23 Issued in NH
Practice address
282 Route 101 # Units910
Amherst, NH 03031-1706
Phone
(603) 249-8883
NPI assigned
Oct 11, 2018
Last updated
Jun 11, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 11, 2019

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 045164-23 NH Primary

Addresses

Primary practice location

282 Route 101 # Units910
Amherst, NH 03031-1706

Mailing address

282 Route 101 # Units910
Amherst, NH 03031-1706

Other identifiers 1

IdentifierTypeStateIssuer
045164-23OtherNHSTATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
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
I20200814002539 NH Practitioner - Nurse Practitioner 0547686917 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
045164-23NHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Derry Medical Center, PA PastSince Feb 1, 2020 Accepting new patients

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": "1539216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560211200000",
    "number": "1619442092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "282 ROUTE 101 # UNITS910",
            "city": "AMHERST",
            "state": "NH",
            "postal_code": "030311706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "282 ROUTE 101 # UNITS910",
            "city": "AMHERST",
            "state": "NH",
            "postal_code": "030311706",
            "telephone_number": "603-249-8883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SERAFIN",
        "first_name": "JENNIFER",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-11",
        "last_updated": "2019-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NH",
            "license": "045164-23",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "045164-23",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Amherst, NH

Sources for this page

Verify at the official NPI Registry.