Individual provider Active NPI

Jenny Felix Morgan, PA-C

  • Physician Assistant
  • Maitland, FL
National Provider Identifier
1750746590
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9109311 Issued in FL
Practice address
500 Winderley PL
Maitland, FL 32751-7247
Phone
(407) 875-0555
NPI assigned
Dec 21, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9109311 FL Primary

Addresses

Primary practice location

500 Winderley PL
Maitland, FL 32751-7247

Mailing address

500 Winderley PL
Maitland, FL 32751-7247
Phone (407) 875-0555

Other practice location 1

10004 N Dale Mabry Hwy
Ste101
Tampa, FL 33618-4494
Phone (813) 931-3999

Other identifiers 2

IdentifierTypeStateIssuer
P01623915OtherFLRR MEDICARE
T1KM5OtherFLBC/BS FLORIDA BLUE

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
I20160324000384 FL Practitioner - Physician Assistant 6305143033 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA9109311FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Medical Clinic, LLC CurrentSince Feb 29, 2016 Accepting new patients
Florida Medical Clinic LLC CurrentSince Feb 29, 2016 Accepting new patients
Observation Medicine Specialists LLC Past Accepting new patients

Locations

10004 N Dale Mabry Hwy
Ste 101
Tampa, FL 33618
Phone (813) 391-3990

38135 Market Square Dr
Zephyrhills, FL 33542
Phone (352) 567-0188

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1450656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1750746590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 WINDERLEY PL",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327517247",
            "telephone_number": "407-875-0555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 WINDERLEY PL",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327517247",
            "telephone_number": "407-875-0555"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10004 N Dale Mabry Hwy",
            "address_2": "Ste101",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336184494",
            "country_code": "US",
            "telephone_number": "813-931-3999",
            "fax_number": "813-936-7147",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MORGAN",
        "first_name": "JENNY",
        "middle_name": "FELIX",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-21",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9109311",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P01623915",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS FLORIDA BLUE",
            "identifier": "T1KM5",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Maitland, FL

Sources for this page

Verify at the official NPI Registry.