Jennifer Russ Childers, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APRN3253932 Issued in FL

Practice address

121 W Macclenny Ave
Macclenny, FL 32063-2029

Phone

(904) 259-6380

NPI assigned

Aug 11, 2016

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

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, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Minuteclinic LLCGroup PAC ID 6709850241, 576 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles (1 of 5)

Locations

Networks

• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H3359

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.

• Minuteclinic LLC

  • Family Nurse Practitioner
  • Rockville, MD
  • NPI 1134191836

  Family, FL

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1470873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637452800000",
    "number": "1831643485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 W MACCLENNY AVE",
            "city": "MACCLENNY",
            "state": "FL",
            "postal_code": "320632029",
            "telephone_number": "904-259-6380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 W MACCLENNY AVE",
            "city": "MACCLENNY",
            "state": "FL",
            "postal_code": "320632029",
            "telephone_number": "904-259-6380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHILDERS",
        "first_name": "JENNIFER",
        "middle_name": "RUSS",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-11",
        "last_updated": "2021-11-21",
        "certification_date": "2021-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN3253932",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristi Lynee Carter, OT
• Kristyn Carter, APRN
• Charles D. Scarborough M.D.
• Hiep Ngoc Chau, M.D.
• Brianna S Chesteen
• CHS FL, LLC
• Erica L Ciccone, CLC
• CJT Express Transport LLC
• Clair Winston Transportation, LLC
• Joann Mashurn Claridy

• All providers in Macclenny, FL
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 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.
• 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.