Jacqueline Renee Terwilliger, ARNP-C

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

ARNP 1757372 Issued in FL

Practice address

303 N Clyde Morris Blvd
Daytona Beach, FL 32114-2709

Phone

(386) 254-4000

NPI assigned

Mar 23, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Nurse Practitioner

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Florida Clinical Practice Association IncGroup PAC ID 0345146254, 1,886 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Halifax Health Care at Home Home health agency, Port Orange, FL, CCN 108359
• Halifax Health Medical Center Hospital, Daytona Beach, FL, CCN 100017

Merit-based Incentive Payment System (MIPS)

Final score

47.54 of 100Reported as apm

Quality

38.49

Promoting interoperability

0

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles (4 of 6)

Locations

Networks

• Freedom Health HMO Network
• Optimum HealthCare HMO Network

Interoperability endpoints

• Direct secure messaging: jterwilliger229968@direct.shands.ufl.edu
• FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.72538

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.

• Florida Clinical Practice Association Inc

  • Surgery Physician
  • Gainesville, FL
  • NPI 1063463768

  FL

  Medicare reassignment Care Compare group NPD
• Florida Clinical Practice Association Inc

  • Durable Medical Equipment & Medical Supplies
  • Ocala, FL
  • NPI 1609529478
  Care Compare group NPD
• Florida Clinical Practice Association Inc

  • Clinical Medical Laboratory
  • Gainesville, FL
  • NPI 1326108903
  Care Compare group
• Florida Clinical Practice Association Inc

  • Durable Medical Equipment & Medical Supplies
  • Deltona, FL
  • NPI 1376133892
  Care Compare group
• Florida Clinical Practice Association Inc

  • Durable Medical Equipment & Medical Supplies
  • Summerfield, FL
  • NPI 1861976516
  Care Compare group
• Halifax Healthcare Systems Inc

  • Family Medicine Physician
  • Daytona Beach, FL
  • NPI 1245283530
  NPD (past)
• Idc of Volusia, LLC

  • Infectious Disease Physician
  • New Smyrna Beach, FL
  • NPI 1154372241
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Daytona Area Senior Services

  • Home Health Agency
  • Daytona Beach, FL
  • NPI 1194775395
  Care Compare affiliation
• Halifax Hospital Medical Center

  • General Acute Care Hospital
  • Daytona Beach, FL
  • NPI 1811991227

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1143072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480636800000",
    "number": "1790745909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1833 N PENINSULA AVE",
            "city": "NEW SMYRNA BEACH",
            "state": "FL",
            "postal_code": "321692017",
            "telephone_number": "386-423-9355",
            "fax_number": "386-423-9355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 N CLYDE MORRIS BLVD",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321142709",
            "telephone_number": "386-254-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TERWILLIGER",
        "first_name": "JACQUELINE",
        "middle_name": "RENEE",
        "credential": "ARNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-23",
        "last_updated": "2016-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "ARNP 1757372",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "308261000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Oni Mandisa Templeton, RMFTI
• Terra Acqua Day Spa Inc
• Terrace of Daytona Beach
• Terrace of Daytona Beach LLC
• Terrace of Daytona Beach, LLC
• Zachary Clyde Terwilliger, M.D.
• TGL Precision Wellness, LLC
• Jerusha Thacker
• Roger Rangarajan Thayer, DMD
• The Arc of Volusia, Inc.

• All providers in Daytona Beach, FL
• Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.