Individual provider Active NPI

Jennifer C Macdonald, ARNP

  • Adult Health Nurse Practitioner
  • Orange City, FL
National Provider Identifier
1710974175
Registry record updated Nov 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
ARNP2615892 Issued in FL
Practice address
2877 Wellness Ave
Orange City, FL 32763-8396
Phone
(386) 668-4650
Fax
(386) 668-4649
NPI assigned
Sep 30, 2005
Last updated
Nov 28, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X ARNP2615892 FL Primary

Addresses

Primary practice location

2877 Wellness Ave
Orange City, FL 32763-8396

Mailing address

2877 Wellness Ave
Orange City, FL 32763-8396
Phone (386) 668-4650

Other identifiers 1

IdentifierTypeStateIssuer
303851700MedicaidFL

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
I20090311000655 FL Practitioner - Nurse Practitioner 9335205699 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Hospital Healthcare Partners, IncGroup PAC ID 7012266836, 621 clinicians

Practice addresses (Care Compare)

600 Palmetto St
New Smyrna Beach, FL 32168-7327
Phone (386) 424-5000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Hospital Healthcare Partners, Inc CurrentSince Jun 6, 2021 Accepting new patients
Florida Kidney and Hypertension Specialists PA CurrentSince Jul 30, 2012 Accepting new patients
Santa Rosa de Lima Medical PA Past Accepting new patients

Locations

701 W Plymouth Ave
Deland, FL 32720
Phone (386) 943-3160

742 W Plymouth Ave
Deland, FL 32720
Phone (386) 736-8622

600 Palmetto St
New Smyrna Beach, FL 32168
Phone (386) 424-3850

1055 Saxon Blvd
Orange City, FL 32763
Phone (386) 917-5000

2877 Wellness Ave
Orange City, FL 32763
Phone (386) 668-4650

Networks

  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: jmacdonald70868@adventhealth.direct-ci.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, 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": "1128038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354060800000",
    "number": "1710974175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2877 WELLNESS AVE",
            "city": "ORANGE CITY",
            "state": "FL",
            "postal_code": "327638396",
            "telephone_number": "386-668-4650",
            "fax_number": "386-668-4649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2877 WELLNESS AVE",
            "city": "ORANGE CITY",
            "state": "FL",
            "postal_code": "327638396",
            "telephone_number": "386-668-4650",
            "fax_number": "386-668-4649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACDONALD",
        "first_name": "JENNIFER",
        "middle_name": "C",
        "name_prefix": "Mrs.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-30",
        "last_updated": "2012-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "ARNP2615892",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "303851700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange City, FL

Sources for this page

Verify at the official NPI Registry.