NPIMap

Individual provider Active NPI

Colleen Jennings, CRNP

  • Nurse Practitioner
  • Philadelphia, PA
National Provider Identifier
1942771001
Registry record updated Jun 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
SP019531 Issued in PA
Practice address
230 N Broad St FL 15
Philadelphia, PA 19102-1121
Phone
(215) 762-7735
Fax
(215) 762-4877
NPI assigned
Dec 16, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X SP019531 PA Primary

Addresses

Primary practice location

230 N Broad St FL 15
Philadelphia, PA 19102-1121

Mailing address

2450 W Hunting Park Ave
Philadelphia, PA 19129-1302
Phone (215) 707-2433

Other practice location 1

925 Chestnut St Ste 320A
Philadelphia, PA 19107-4216
Phone (215) 955-8874

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190410001020 PA Practitioner - Nurse Practitioner 9931440401 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Temple Faculty Practice Plan IncGroup PAC ID 0345588711, 1,325 clinicians

Practice addresses (Care Compare)

3401 N Broad St
Philadelphia, PA 19140-5103
Phone (215) 707-3008

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Drexel University CurrentSince Feb 27, 2019 Accepting new patients
Temple Faculty Practice Plan Inc Current Accepting new patients
Drexel University Current Accepting new patients
Jefferson University Physicians CurrentSince Sep 1, 2019 Accepting new patients
Temple Faculty Practice Plan Inc CurrentSince May 3, 2021 Accepting new patients
Drexel University CurrentSince Feb 27, 2019 Accepting new patients
Temple Faculty Practice Plan Inc CurrentSince May 3, 2021 Accepting new patients
Temple Faculty Practice Plan Inc Past Accepting new patients

Locations

925 Chestnut St
Fl 3
Philadelphia, PA 19107
Phone (215) 503-6654

925 Chestnut St
Fl 6
Philadelphia, PA 19107
Phone (215) 955-6760

1601 Cherry St
Ste 11511
Philadelphia, PA 19102

230 N Broad St
Fl 15
Philadelphia, PA 19102
Phone (215) 762-2640

1427 Vine St
Fl 2
Philadelphia, PA 19102
Phone (215) 762-2530

333 Cottman Ave
Philadelphia, PA 19111
Phone (215) 728-3893

7600 Central Ave
Philadelphia, PA 19111
Phone (215) 707-5522

925 Chestnut St
Ste 320A
Philadelphia, PA 19107
Phone (215) 955-1175

3401 N Broad St
Philadelphia, PA 19140
Phone (215) 707-3807

2450 W Hunting Park Ave
Philadelphia, PA 19129
Phone (215) 707-2433

Organizations & group practices 8

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.

Hospital & facility affiliations 8

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

NPI Registry JSON

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

{
    "created_epoch": "1544918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622678400000",
    "number": "1942771001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2450 W HUNTING PARK AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191291302",
            "telephone_number": "215-707-2433",
            "fax_number": "215-707-3677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 N BROAD ST FL 15",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191021121",
            "telephone_number": "215-762-7735",
            "fax_number": "215-762-4877"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "925 Chestnut St Ste 320A",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191074216",
            "country_code": "US",
            "telephone_number": "215-955-8874",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JENNINGS",
        "first_name": "COLLEEN",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-16",
        "last_updated": "2021-06-03",
        "certification_date": "2021-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP019531",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.