Jennifer Anne Haney, PA-C, NBC-HWC

Primary specialty

Health & Wellness CoachTaxonomy code 171400000X

License

3922917 Issued in AL

Practice address

110 12TH St N
Birmingham, AL 35203-1537

Phone

(855) 255-2362

NPI assigned

May 28, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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.

• Pack Health, LLC

  • Health & Wellness Coach
  • Birmingham, AL
  • NPI 1710391206
  NPD

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

{
    "created_epoch": "1590624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719792000000",
    "number": "1689297384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 12TH ST N",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352031537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 12TH ST N",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352031537",
            "telephone_number": "855-255-2362"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "619 19th St S Ste P915",
            "address_purpose": "LOCATION",
            "city": "Birmingham",
            "state": "AL",
            "postal_code": "352331900",
            "country_code": "US",
            "telephone_number": "205-975-0512",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1201 11th Ave S",
            "address_purpose": "LOCATION",
            "city": "Birmingham",
            "state": "AL",
            "postal_code": "352053423",
            "country_code": "US",
            "telephone_number": "205-934-3411",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HANEY",
        "first_name": "JENNIFER",
        "middle_name": "ANNE",
        "credential": "PA-C, NBC-HWC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-28",
        "last_updated": "2024-07-01",
        "certification_date": "2024-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AL",
            "license": "PA.1621",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AL",
            "license": "PA.1621",
            "primary": false
        },
        {
            "code": "171400000X",
            "taxonomy_group": "",
            "desc": "Health & Wellness Coach",
            "state": "AL",
            "license": "3922917",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@packhealth.com",
            "affiliation": "N",
            "endpointDescription": "secure inbox",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "110 12th St N",
            "city": "Birmingham",
            "state": "AL",
            "country_code": "US",
            "postal_code": "352031537",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Health & Wellness Coach in Birmingham, AL
• Providers in Birmingham, AL by specialty
• Health & Wellness Coach in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.