Individual provider Active NPI

Jenelle Fernandez, M.D.

  • Pediatric Gastroenterology Physician
  • Mobile, AL
National Provider Identifier
1790147874
Registry record updated Apr 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Gastroenterology PhysicianTaxonomy code 2080P0206X
License
MD.48324 Issued in AL
Practice address
1601 Center St
Mobile, AL 36604-1541
Phone
(251) 410-5437
Fax
(251) 434-3851
NPI assigned
Mar 28, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Gastroenterology Physician 2080P0206X ME139345 FL
Pediatric Gastroenterology Physician 2080P0206X MD.48324 AL Primary

Addresses

Primary practice location

1601 Center St
Mobile, AL 36604-1541

Mailing address

PO Box 746450
Atlanta, GA 30374-6450
Phone (866) 401-3057

Other identifiers 2

IdentifierTypeStateIssuer
4HYBAOtherFLBLUE CROSS BLUE SHIELD
114879000MedicaidFL

Electronic endpoints 2

TypeEndpointUseAffiliation
CONNECT URL https://www.orlandohealth.com/pediatric-gastroenterology-fellowship Direct
Direct Messaging Address fernandez29976@direct.tgh.org

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240617001149 AL Practitioner - Gastroenterology 6305100017 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD.48324ALMDPediatric Gastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
USA Health Physician Billing Services LLC CurrentSince May 15, 2024 Accepting new patients
USA Health Physician Billing Services LLC CurrentSince May 15, 2024 Accepting new patients

Locations

1601 Center St
Mobile, AL 36604
Phone (251) 410-5437

75 S University Blvd
Unit 6500
Mobile, AL 36608
Phone (251) 445-8282

75 S University Blvd
Unit 6000
Mobile, AL 36608
Phone (251) 660-5555

Interoperability endpoints

  • Direct secure messaging: fernandez29976@direct.tgh.org

Organizations & group practices 2

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": "1459123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713312000000",
    "number": "1790147874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746450",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303746450",
            "telephone_number": "866-401-3057",
            "fax_number": "308-868-6430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 CENTER ST",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366041541",
            "telephone_number": "251-410-5437",
            "fax_number": "251-434-3851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNANDEZ",
        "first_name": "JENELLE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-28",
        "last_updated": "2024-04-17",
        "certification_date": "2024-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "FL",
            "license": "ME139345",
            "primary": false
        },
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "AL",
            "license": "MD.48324",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "4HYBA",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "114879000",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.orlandohealth.com/pediatric-gastroenterology-fellowship",
            "affiliation": "N",
            "endpointDescription": "Orlando Health GI Fellowship Program",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "None",
            "address_1": "60 W Gore St",
            "city": "Orlando",
            "state": "FL",
            "country_code": "US",
            "postal_code": "328061141",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "fernandez29976@direct.tgh.org",
            "affiliation": "N",
            "address_1": "2 Tampa General Cir",
            "city": "Tampa",
            "state": "FL",
            "country_code": "US",
            "postal_code": "336063571",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mobile, AL

Sources for this page

Verify at the official NPI Registry.