Active NPI
Jackie Jean Jennings, RPSGT
- Other Technician
- Dadeville, AL
National Provider Identifier
1790796712
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Other Technician
- License
- 729
- Practice address
- 183 Griffin Shoals Rd
Dadeville, AL 36853-3106 - Phone
- (256) 825-9424
- Fax
- (256) 825-2078
- NPI assigned
- Aug 11, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Other Technician | 247200000X | 729 | AL | Primary |
Addresses
Primary practice location
183 Griffin Shoals Rd
Dadeville, AL 36853-3106
Mailing address
183 Griffin Shoals Rd
Dadeville, AL 36853-3106
Phone (256) 825-9424
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
| License | State | Type | Specialty |
|---|---|---|---|
| 729 | AL | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155254400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1790796712",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "183 GRIFFIN SHOALS RD",
"city": "DADEVILLE",
"state": "AL",
"postal_code": "368533106",
"telephone_number": "256-825-9424",
"fax_number": "256-825-2078"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "183 GRIFFIN SHOALS RD",
"city": "DADEVILLE",
"state": "AL",
"postal_code": "368533106",
"telephone_number": "256-825-9424",
"fax_number": "256-825-2078"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JENNINGS",
"first_name": "JACKIE",
"middle_name": "JEAN",
"name_prefix": "Mrs.",
"credential": "RPSGT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "247200000X",
"taxonomy_group": "",
"desc": "Technician, Other",
"state": "AL",
"license": "729",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dadeville, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.