Philip Frank Alain Jessen, APRN

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

APRN3175792 Issued in FL

Practice address

1005 Mar Walt Drive
Internal Medicine Department
Fort Walton Beach, FL 32547-6707

Phone

(850) 863-8202

Fax

(850) 862-6148

NPI assigned

Jul 16, 2015

Sex

Male

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 2

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, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

White-Wilson Medical Center PAGroup PAC ID 4082510607, 48 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Centerwell Home Health Home health agency, Shalimar, FL, CCN 107240
• HCA Florida Fort Walton-Destin Hospital Hospital, Fort Walton Beach, FL, CCN 100223
• HCA Florida Twin Cities Hospital Hospital, Niceville, FL, CCN 100054
• Sacred Heart Hospital on the Emerald Coast Hospital, Miramar Beach, FL, CCN 100292

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: philip.jessen.1@21123.direct.athenahealth.com

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.

• White-Wilson Medical Center PA

  dba White-Wilson Medical Center

  • Clinic/Center
  • Fort Walton Beach, FL
  • NPI 1467437277
  Medicare reassignment Care Compare group NPD
• WW Medical Center, PA

  dba White-Wilson Medical Center

  • Clinic/Center
  • Fort Walton Beach, FL
  • NPI 1225981707
  Medicare reassignment

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

• Centerwell Health Services (Certified), Inc.

  dba Centerwell Home Health

  • Home Health Agency
  • Shalimar, FL
  • NPI 1518991215
  Care Compare affiliation Name & address match
• Ascension Sacred Heart Emerald Coast

  • General Acute Care Hospital
  • Miramar Beach, FL
  • NPI 1558391771
  Care Compare affiliation
• Fort Walton Beach Medical Center, Inc.

  dba HCA Florida Fort Walton-Destin Hospital

  • General Acute Care Hospital
  • Fort Walton Beach, FL
  • NPI 1639128820
  Care Compare affiliation
• Okaloosa Hospital Inc

  dba HCA Florida Twin Cities Hospital

  • General Acute Care Hospital
  • Niceville, FL
  • NPI 1891732988
  Care Compare affiliation

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

{
    "created_epoch": "1437004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600992000000",
    "number": "1871977173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1005 MAR WALT DRIVE",
            "address_2": "INTERNAL MEDICINE",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325476707",
            "telephone_number": "850-863-8202",
            "fax_number": "850-862-6148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 MAR WALT DRIVE",
            "address_2": "INTERNAL MEDICINE DEPARTMENT",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325476707",
            "telephone_number": "850-863-8202",
            "fax_number": "850-862-6148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JESSEN",
        "first_name": "PHILIP",
        "middle_name": "FRANK ALAIN",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-07-16",
        "last_updated": "2020-09-25",
        "certification_date": "2020-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN3175792",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSFL",
            "identifier": "Y0S6Y",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "015293800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer R Goette OD PA (Special-Eyes Vision Center)
• Jeremiah D. Patrick, D.M.D., P.a. (Patrick Endodontics)
• Devon N Jernigan, PT, DPT
• Carl S Jerome, D.C.
• Jerzy Grzebieluch, MD, LLC
• Christian Jimenez, DMD
• Rachel Robinson Joern, PT
• John C Chaney MD FCCP PA
• John C Warburton MD PA
• John Cottam MD PA

• Nurse Practitioner in Fort Walton Beach, FL
• Providers in Fort Walton Beach, FL by specialty
• Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2020; 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.