Jennifer Prince, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

14479 Issued in CA

Practice address

1111 N China Lake Blvd Ste 190
Ridgecrest, CA 93555-3131

Phone

(760) 499-3855

Fax

(760) 499-3870

NPI assigned

Mar 24, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in DC, VA, CA3 enrollments

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 3

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jennifer.prince.1@7598.direct.athenahealth.com
• FHIR API: https://fhir-myrecord.cerner.com/r4/663c4c6d-1396-44a4-b589-c11a968d4876/

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.

• Ridgecrest Regional Hospital

  • Critical Access Hospital
  • Ridgecrest, CA
  • NPI 1447253125
  Medicare reassignment NPD
• Valley Children'S Medical Group

  • Pediatrics Physician
  • Modesto, CA
  • NPI 1437555265
  Medicare reassignment NPD
• Emergency Medicine Associates P.a., P.C.

  • Emergency Medicine Physician
  • Falls Church, VA
  • NPI 1134117393

  DC, Pediatrics

  Medicare reassignment NPD
• Emergency Medicine Associates, P.a.,P.C.

  • Internal Medicine Physician
  • Dulles, VA
  • NPI 1376917070
  Medicare reassignment NPD
• Ridgecrest Regional Hospital

  • Ambulatory Surgical Clinic/Center
  • Ridgecrest, CA
  • NPI 1164067971
  NPD
• Emergency Medicine Associates P.a., P.C.

  • Internal Medicine Physician
  • Culpeper, VA
  • NPI 1881559102
  NPD
• Valley Children'S Hospital

  • Children's Hospital
  • Madera, CA
  • NPI 1952312043
  NPD (past)
• Garnet Health Medical Center

  • General Acute Care Hospital
  • Middletown, NY
  • NPI 1609875772
  NPD (past)
• Yukon-Kuskokwim Health Corporation

  • Rural Acute Care Hospital
  • Bethel, AK
  • NPI 1063567691
  NPD (past)

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

{
    "created_epoch": "1300924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621296000000",
    "number": "1811296288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2152 REDWOOD CRST",
            "city": "VISTA",
            "state": "CA",
            "postal_code": "920817381",
            "telephone_number": "917-635-1493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 N CHINA LAKE BLVD STE 190",
            "city": "RIDGECREST",
            "state": "CA",
            "postal_code": "935553131",
            "telephone_number": "760-499-3855",
            "fax_number": "760-499-3870"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "829 Chief Eddie Hoffman Hwy",
            "address_purpose": "LOCATION",
            "city": "Bethel",
            "state": "AK",
            "postal_code": "99559",
            "country_code": "US",
            "telephone_number": "907-677-7501",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1000 Vale Terrance Dr",
            "address_purpose": "LOCATION",
            "city": "Vista",
            "state": "CA",
            "postal_code": "92084",
            "country_code": "US",
            "telephone_number": "760-631-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PRINCE",
        "first_name": "JENNIFER",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-03-24",
        "last_updated": "2021-05-18",
        "certification_date": "2021-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "20A14479",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "14479",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jenniferprince@rrh.medalliesdirect.net",
            "affiliation": "N",
            "endpointDescription": "RRH Direct Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "1111 N China Lake Blvd Ste 190",
            "city": "Ridgecrest",
            "state": "CA",
            "country_code": "US",
            "postal_code": "935553131",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Lena Pokol
• Katy J Portillo
• Ehssan Pour Ramezani
• Lindsay Pratt, RBT
• Melissa Ann Price, LCSW
• Samantha Lee Proctor
• Progressive Ambulance, Inc.
• Phoebelyn Gerez Quero, OTR/L
• Ernest Andrew Quier, CRNA
• Jill Kristine Rachels, RD

• Family Medicine Physician in Ridgecrest, CA
• Providers in Ridgecrest, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.