Individual provider Active NPI

Jennifer Miller, APRN, MSN, ACNP-BC

  • Nurse Practitioner
  • Pensacola, FL
National Provider Identifier
1871833053
Registry record updated Jan 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN11008896 Issued in FL
Practice address
5151 N 9TH Ave Ste 200
Pensacola, FL 32504-8721
Phone
(850) 416-4970
NPI assigned
Feb 25, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 1103429 AL
Nurse Practitioner 363L00000X APRN11008896 FL Primary

Addresses

Primary practice location

5151 N 9TH Ave Ste 200
Pensacola, FL 32504-8721

Mailing address

4205 Belfort Rd Ste 4015
Jacksonville, FL 32216-3623
Phone (904) 450-6014

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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

Enrollment IDStateProvider typePAC IDDetails
I20130502000161 AL Practitioner - Nurse Practitioner 8325285737

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN11008896FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of South Alabama Health Care Authority CurrentSince May 1, 2020 Accepting new patients
Sacred Heart Health System, Inc. Current Accepting new patients
Bay Area Inpatient Physicians LLC Past Accepting new patients
Heart Group of the Eastern Shore, P.C. PastSince Apr 1, 2006 Accepting new patients

Locations

2423 Schillinger Rd S
Mobile, AL 36695
Phone (251) 660-5950

6701 Airport Blvd
#A1
Mobile, AL 36608
Phone (251) 633-8880

75 S University Blvd
Ste 6000A
Mobile, AL 36608
Phone (251) 660-5787

4205 Belfort Rd
Ste 4015
Jacksonville, FL 32216
Phone (904) 296-5691

5151 N 9th Ave
Ste 200
Pensacola, FL 32504
Phone (850) 416-4188

Interoperability endpoints

  • Direct secure messaging: jennifer.miller.1@9582.direct.athenahealth.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1361750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609977600000",
    "number": "1871833053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4205 BELFORT RD STE 4015",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322163623",
            "telephone_number": "904-450-6014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5151 N 9TH AVE STE 200",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325048721",
            "telephone_number": "850-416-4970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "JENNIFER",
        "credential": "APRN, MSN, ACNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-25",
        "last_updated": "2021-01-07",
        "certification_date": "2021-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "AL",
            "license": "1103429",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN11008896",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pensacola, FL

Sources for this page

Verify at the official NPI Registry.