Jennifer Rae Witt, CPNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

APRN11008019 Issued in FL

Practice address

150 SW Chamber CT Ste 101
Port St Lucie, FL 34986-3413

Phone

(772) 301-0123

Fax

(772) 301-0124

NPI assigned

Apr 6, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 3

Other names 1

• Jennifer Rae Tigner Former name

Medicare fee-for-service enrollment

Enrolled in NC, GA2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Pediatric Nurse Practitioner, Nurse Practitioner

State licenses

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 and National Provider Directory roles.

• Carolinas Physicians Network Inc

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Charlotte, NC
  • NPI 1477878890
  Medicare reassignment NPD
• Choa Multispecialty, LLC

  • Pediatrics Physician
  • Brookhaven, GA
  • NPI 1437493467
  Medicare reassignment NPD
• Carolinas Physicians Network Inc

  • Endocrinology, Diabetes & Metabolism Physician
  • Charlotte, NC
  • NPI 1437038544
  NPD
• Carolinas Physicians Network, Inc.

  • Urology Physician
  • Lincolnton, NC
  • NPI 1336472596
  NPD
• Choa Hospital Based, LLC

  • Pediatrics Physician
  • Brookhaven, GA
  • NPI 1457695488
  NPD
• Egleston Pediatric Group

  • Pediatrics Physician
  • Atlanta, GA
  • NPI 1811041452
  NPD
• Optimal Care Pediatrics LLC

  • Pediatrics Physician
  • Port Saint Lucie, FL
  • NPI 1861909384
  NPD (past)
• Carolinas Physicians Network Inc

  • Family Medicine Physician
  • Charlotte, NC
  • NPI 1386653830
  NPD (past)
• Carolinas Physicians Network Inc

  • Family Medicine Physician
  • Charlotte, NC
  • NPI 1437168937
  NPD (past)
• Carolinas Physicians Network Inc

  • Family Medicine Physician
  • Charlotte, NC
  • NPI 1497762686
  NPD (past)
• Carolinas Physicians Network Inc

  • Family Medicine Physician
  • Concord, NC
  • NPI 1902049190
  NPD (past)
• Union Urgent Care LLC

  • Durable Medical Equipment & Medical Supplies
  • Monroe, NC
  • NPI 1063421469
  NPD (past)

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

{
    "created_epoch": "1175817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699315200000",
    "number": "1629190731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 SW CHAMBER CT STE 101",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349863413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 SW CHAMBER CT STE 101",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349863413",
            "telephone_number": "772-301-0123",
            "fax_number": "772-301-0124"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6025 Blakeney Park Drive",
            "address_2": "Suite 100",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282775704",
            "country_code": "US",
            "telephone_number": "704-667-4480",
            "fax_number": "704-667-4499",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WITT",
        "first_name": "JENNIFER",
        "middle_name": "RAE",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-06",
        "last_updated": "2023-11-07",
        "certification_date": "2023-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "FL",
            "license": "APRN11008019",
            "primary": true
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NC",
            "license": "0050-1620",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5001620",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NC",
            "license": "203964",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7005607",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP3325",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1629190731",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "TIGNER",
            "middle_name": "RAE",
            "credential": "CPNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jessica Wilson
• Kaley Noelle Wimmer
• Robin Winkler
• Sabrina Winn
• Yvette Wirta-Clarke, DO
• Estefanie A Witteman, PA-C
• Nicole Wittman
• Ann Maree Wittock-Brown
• Sarah Wolf, APRN
• Matthew Wolfe, DPT

• Pediatric Nurse Practitioner in Port St Lucie, FL
• Providers in Port St Lucie, FL by specialty
• Pediatric Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 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.