Individual provider Active NPI

Jennifer Joy St. John, CRNP

  • Nurse Practitioner
  • Pell City, AL
National Provider Identifier
1649222027
Registry record updated Jul 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
1-070364 Issued in AL
Practice address
74 Plaza Dr
Pell City, AL 35125-9370
Phone
(205) 814-9284
Fax
(205) 814-9626
NPI assigned
May 16, 2006
Last updated
Jul 2, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 1-070364 AL Primary

Addresses

Primary practice location

74 Plaza Dr
Pell City, AL 35125-9370

Mailing address

74 Plaza Dr
Pell City, AL 35125-9370
Phone (205) 814-9284

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
I20061221000149 AL Practitioner - Nurse Practitioner 0042219032 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Birmingham Internal Medicine Associates, LLCGroup PAC ID 1658341193, 123 clinicians

Practice addresses (Care Compare)

7191 Cahaba Valley Rd
Suite 300
Hoover, AL 35242-6461
Phone (205) 814-7206

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Certified Registered Nurse, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1-070364ALMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mary Sue Suggs Current Accepting new patients
Birmingham Internal Medicine Associates, LLC CurrentSince Dec 1, 2020 Accepting new patients

Locations

7191 Cahaba Valley Rd
Ste 300
Hoover, AL 35242
Phone (205) 930-2060

1508 Cogswell Ave
Pell City, AL 35125
Phone (205) 814-1598

70 Plaza Dr
Pell City, AL 35125
Phone (205) 814-9284

74 Plaza Dr
Pell City, AL 35125
Phone (205) 814-7272

Interoperability endpoints

  • Direct secure messaging: jennifer.st.john.1@15135.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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562025600000",
    "number": "1649222027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "74 PLAZA DR",
            "city": "PELL CITY",
            "state": "AL",
            "postal_code": "351259370",
            "telephone_number": "205-814-9284",
            "fax_number": "205-814-9626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "74 PLAZA DR",
            "city": "PELL CITY",
            "state": "AL",
            "postal_code": "351259370",
            "telephone_number": "205-814-9284",
            "fax_number": "205-814-9626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ST. JOHN",
        "first_name": "JENNIFER",
        "middle_name": "JOY",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-16",
        "last_updated": "2019-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AL",
            "license": "1-070364",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pell City, AL

Sources for this page

Verify at the official NPI Registry.