Individual provider Active NPI

Jennifer K. Ronderos, M.D.

  • Family Medicine Physician
  • Saraland, AL
National Provider Identifier
1942216452
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
00020619 Issued in AL
Practice address
88 Saraland Loop
Saraland, AL 36571-2400
Phone
(251) 675-7433
Fax
(251) 675-3470
NPI assigned
Aug 1, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 00020619 AL Primary

Addresses

Primary practice location

88 Saraland Loop
Saraland, AL 36571-2400

Mailing address

88 Saraland Loop
Saraland, AL 36571-2400
Phone (251) 675-7433

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080826000532 AL Practitioner - General Practice 2769557719 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
00020619ALMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Greater Mobile Urgent Care Family Medicine CurrentSince Nov 1, 2020 Accepting new patients
Greater Mobile Urgent Care Family Medicine CurrentSince Nov 1, 2020 Accepting new patients
Gmuc of Springhill LLC Family Medicine CurrentSince Nov 1, 2020 Accepting new patients
Alabama CVS Pharmacy LLC PastSince Nov 1, 2020 Accepting new patients

Locations

2350 Schillinger Rd S
Ste A
Mobile, AL 36695
Phone (251) 633-0123

4402 Old Shell Rd
Mobile, AL 36608
Phone (251) 633-0123

7943 Moffett Rd
Semmes, AL 36575
Phone (251) 445-7618

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1942216452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "88 SARALAND LOOP",
            "city": "SARALAND",
            "state": "AL",
            "postal_code": "365712400",
            "telephone_number": "251-675-7433",
            "fax_number": "251-675-3470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "88 SARALAND LOOP",
            "city": "SARALAND",
            "state": "AL",
            "postal_code": "365712400",
            "telephone_number": "251-675-7433",
            "fax_number": "251-675-3470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RONDEROS",
        "first_name": "JENNIFER",
        "middle_name": "K.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "00020619",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saraland, AL

Sources for this page

Verify at the official NPI Registry.