Active NPI
Valorey Serita Jenkins
- Family Nurse Practitioner
- Panama City, FL
National Provider Identifier
1962023580
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- APRN11005723
- Practice address
- 5400 Bayline Dr
Panama City, FL 32404-5492 - Phone
- (850) 769-1455
- NPI assigned
- May 5, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | APRN11005723 | FL | Primary |
Addresses
Primary practice location
5400 Bayline Dr
Panama City, FL 32404-5492
Mailing address
546 J H Crews Cir
Panama City, FL 32404-2262
Phone (850) 814-6422
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220210000106 | FL | Practitioner - Nurse Practitioner | 5092108324 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1588636800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1634083200000",
"number": "1962023580",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "546 J H CREWS CIR",
"city": "PANAMA CITY",
"state": "FL",
"postal_code": "324042262",
"telephone_number": "850-814-6422"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5400 BAYLINE DR",
"city": "PANAMA CITY",
"state": "FL",
"postal_code": "324045492",
"telephone_number": "850-769-1455"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JENKINS",
"first_name": "VALOREY",
"middle_name": "SERITA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-05-05",
"last_updated": "2021-10-13",
"certification_date": "2021-10-13",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "FL",
"license": "APRN11005723",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Panama City, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2021; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.