Individual provider Active NPI

Jennifer Shea Sanders Pope, DNP, CRNP, FNP-C

  • Family Nurse Practitioner
  • Robertsdale, AL
National Provider Identifier
1720477151
Registry record updated Nov 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
9390693 Issued in FL
Practice address
18317 US Highway 90
Robertsdale, AL 36567
Phone
(251) 947-2000
NPI assigned
Jan 22, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2021

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 9390693 FL Primary

Addresses

Primary practice location

18317 US Highway 90
Robertsdale, AL 36567

Mailing address

18317 US Highway 90
Robertsdale, AL 36567
Phone (251) 947-2000

Other identifiers 3

IdentifierTypeStateIssuer
Y0RN5OtherFLBCBS
ID056ZOtherFLMEDICARE INDIVIDUAL PROVIDER PTAN
K4348OtherFLMEDICARE GROUP PTAN

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
I20170119001168 AL Practitioner - Nurse Practitioner 4789903295 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Imc-Central Baldwin Physicians, LLC.Group PAC ID 3274825328, 4 clinicians

Practice addresses (Care Compare)

18317 US Hwy 90
Robertsdale, AL 36567
Phone (251) 947-2000

Hospital & facility affiliations

  • Thomas Hospital Hospital, Fairhope, AL, CCN 010100

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9390693FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Imc-Diagnostic and Medical Clinic LLC CurrentSince Aug 3, 2021 Accepting new patients
Imc-Eastern Shore Adult Medicine, LLC CurrentSince Oct 28, 2019 Accepting new patients
Imc-Emergency Physicians LLC CurrentSince Nov 5, 2022 Accepting new patients
Imc-Central Baldwin Physicians LLC CurrentSince Jan 1, 2017 Accepting new patients
Imc-Diagnostic and Medical Clinic LLC CurrentSince Aug 3, 2021 Accepting new patients

Locations

1815 Hand Ave
Bay Minette, AL 36507
Phone (251) 279-1553

27961 US Highway 98
Ste 12
Daphne, AL 36526
Phone (251) 445-0075

300 Greeno Rd S
Fairhope, AL 36532
Phone (251) 928-9560

300 Greeno Rd S
#B
Fairhope, AL 36532
Phone (251) 929-3424

1725 Spring Hill Ave
Mobile, AL 36604
Phone (251) 435-1366

1700 Spring Hill Ave
Ste 100
Mobile, AL 36604

Interoperability endpoints

  • Direct secure messaging: jpope30000@directinfirmaryhealth.org

Organizations & group practices 5

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.

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": "1421884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637712000000",
    "number": "1720477151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18317 US HIGHWAY 90",
            "city": "ROBERTSDALE",
            "state": "AL",
            "postal_code": "36567",
            "telephone_number": "251-947-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18317 US HIGHWAY 90",
            "city": "ROBERTSDALE",
            "state": "AL",
            "postal_code": "36567",
            "telephone_number": "251-947-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POPE",
        "first_name": "JENNIFER",
        "middle_name": "SHEA SANDERS",
        "name_prefix": "Dr.",
        "credential": "DNP, CRNP, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-22",
        "last_updated": "2021-11-24",
        "certification_date": "2021-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "9390693",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "Y0RN5",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE INDIVIDUAL PROVIDER PTAN",
            "identifier": "ID056Z",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PTAN",
            "identifier": "K4348",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Robertsdale, AL

Sources for this page

Verify at the official NPI Registry.