Individual provider Active NPI

Michelle Leigh Jtineant, MSN, CRNP

  • Family Nurse Practitioner
  • Madison, AL
National Provider Identifier
1639418908
Registry record updated May 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1-087946 Issued in AL
Practice address
300 Sun Temple Dr
Madison, AL 35758-5919
Phone
(256) 325-9111
Fax
(256) 325-9113
NPI assigned
Feb 6, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 8, 2024

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 1-087946 AL Primary

Addresses

Primary practice location

300 Sun Temple Dr
Madison, AL 35758-5919

Mailing address

300 Sun Temple Dr
Madison, AL 35758-5919
Phone (256) 325-9111

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
I20171102001796 AL Practitioner - Nurse Practitioner 5597021840 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse, Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1-087946ALMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
North Alabama Medical Clinic PC CurrentSince Apr 1, 2024 Accepting new patients
Aspire Primary Care LLC CurrentSince Sep 25, 2017 Accepting new patients

Locations

600 Saint Clair Ave SW
Ste 22
Huntsville, AL 35801
Phone (256) 533-6003

2006 Franklin St SE
Ste 102
Huntsville, AL 35801
Phone (256) 251-5121

300 Sun Temple Dr
Madison, AL 35758
Phone (256) 325-9111

Interoperability endpoints

  • Direct secure messaging: michelle.jtineant.1@27892.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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1360108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715126400000",
    "number": "1639418908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 SUN TEMPLE DR",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "357585919",
            "telephone_number": "256-325-9111",
            "fax_number": "256-325-9113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 SUN TEMPLE DR",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "357585919",
            "telephone_number": "256-325-9111",
            "fax_number": "256-325-9113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JTINEANT",
        "first_name": "MICHELLE",
        "middle_name": "LEIGH",
        "name_prefix": "Mrs.",
        "credential": "MSN, CRNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-02-06",
        "last_updated": "2024-05-08",
        "certification_date": "2024-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-087946",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, AL

Sources for this page

Verify at the official NPI Registry.