Individual provider Active NPI

Jennifer S Weldon, CRNP

  • Adult Health Nurse Practitioner
  • Birmingham, AL
National Provider Identifier
1952417115
Registry record updated Jul 14, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
145373 Issued in AL
Practice address
817 Princeton Ave SW
Ste 115
Birmingham, AL 35211-1333
Phone
(205) 780-1963
Fax
(205) 780-1967
NPI assigned
Aug 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 145373 AL Primary

Addresses

Primary practice location

817 Princeton Ave SW
Ste 115
Birmingham, AL 35211-1333

Mailing address

817 Princeton Ave SW
Ste 115
Birmingham, AL 35211-1333
Phone (205) 780-1963

Other identifiers 2

IdentifierTypeStateIssuer
51522305OtherALBLUE CROSS OF AL
891007840MedicaidAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
145373ALMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Jefferson Clinic, P.C. Past Accepting new patients

Organizations & group practices 1

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": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184371200000",
    "number": "1952417115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "817 PRINCETON AVE SW",
            "address_2": "STE 115",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352111333",
            "telephone_number": "205-780-1963",
            "fax_number": "205-780-1967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "817 PRINCETON AVE SW",
            "address_2": "STE 115",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352111333",
            "telephone_number": "205-780-1963",
            "fax_number": "205-780-1967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELDON",
        "first_name": "JENNIFER",
        "middle_name": "S",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-21",
        "last_updated": "2007-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "AL",
            "license": "145373",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF AL",
            "identifier": "51522305",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "891007840",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.