Individual provider Active NPI

Jennifer Wenthur, APRN

  • Nurse Practitioner
  • Fort Walton Beach, FL
National Provider Identifier
1669186565
Registry record updated Jan 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
11023203 Issued in FL
Practice address
514 Mary Esther Cut Off NW # Esther
Fort Walton Beach, FL 32548-4047
Phone
(850) 226-8550
NPI assigned
Jan 6, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2023

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 11023203 FL Primary

Addresses

Primary practice location

514 Mary Esther Cut Off NW # Esther
Fort Walton Beach, FL 32548-4047

Mailing address

514 Mary Esther Cut Off NW # Esther
Fort Walton Beach, FL 32548-4047
Phone (850) 226-8550

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
I20230322002037 FL Practitioner - Nurse Practitioner 5597139105 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gulf Coast Immediate Care Center Inc.Group PAC ID 9638172745, 3 clinicians

Practice addresses (Care Compare)

345 Miracle Strip Pkwy SW
Fort Walton Beach, FL 32548-5210
Phone 85024432111003

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11023203FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Quality Urgent Care & Wellness PL CurrentSince Dec 15, 2022 Accepting new patients
Gulf Coast Immediate Care Center Inc. CurrentSince Jul 1, 2025 Accepting new patients
Quality Urgent Care & Wellness PL Current Accepting new patients

Locations

345 Miracle Strip Pkwy SW
Ft Walton Bch, FL 32548
Phone (850) 244-3211

514 Mary Esther Cut Off NW
Ft Walton Bch, FL 32548
Phone (850) 226-8550

5115 N Palafox St
Pensacola, FL 32505
Phone (850) 378-8773

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8204/brand/1/csg/1/fhir/r4
  • Direct secure messaging: jennifer.wenthur.1@8204.direct.athenahealth.com

Organizations & group practices 3

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": "1672963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672963200000",
    "number": "1669186565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "514 MARY ESTHER CUT OFF NW # ESTHER",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325484047",
            "telephone_number": "850-226-8550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "514 MARY ESTHER CUT OFF NW # ESTHER",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325484047",
            "telephone_number": "850-226-8550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WENTHUR",
        "first_name": "JENNIFER",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-06",
        "last_updated": "2023-01-06",
        "certification_date": "2023-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "11023203",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Walton Beach, FL

Sources for this page

Verify at the official NPI Registry.