Individual provider Active NPI

Jennifer L Peoples, APRN

  • Nurse Practitioner
  • Santa Rosa Beach, FL
National Provider Identifier
1790404093
Registry record updated Jul 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
11021479 Issued in FL
Practice address
2048 W County Highway 30a
Santa Rosa Beach, FL 32459-0198
Phone
(850) 201-7879
NPI assigned
Aug 22, 2022
Last updated
Jul 19, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 11021479 FL Primary

Addresses

Primary practice location

2048 W County Highway 30a
Santa Rosa Beach, FL 32459-0198

Mailing address

2048 W County Highway 30a
Santa Rosa Beach, FL 32459-0198
Phone (850) 201-7879

Other identifiers 1

IdentifierTypeStateIssuer
11021478OtherFLFLORIDA APRN LICENSE NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
11021479FLMDNurse Practitioner

Interoperability endpoints

  • Direct secure messaging: peoples@beachesderm.emadirect.md

NPI Registry JSON

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

{
    "created_epoch": "1661126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689724800000",
    "number": "1790404093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2048 W COUNTY HIGHWAY 30A",
            "city": "SANTA ROSA BEACH",
            "state": "FL",
            "postal_code": "324590198",
            "telephone_number": "850-201-7879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2048 W COUNTY HIGHWAY 30A",
            "city": "SANTA ROSA BEACH",
            "state": "FL",
            "postal_code": "324590198",
            "telephone_number": "850-201-7879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEOPLES",
        "first_name": "JENNIFER",
        "middle_name": "L",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-22",
        "last_updated": "2023-07-19",
        "certification_date": "2023-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "11021479",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA APRN LICENSE NUMBER",
            "identifier": "11021478",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2023; 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.