Stephanie D Jernighan

Primary specialty

Developmental TherapistTaxonomy code 222Q00000X

Practice address

2155 Palm Bay Rd NE Ste 7
Palm Bay, FL 32905-2907

Phone

(321) 220-0862

NPI assigned

May 19, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

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.

• Beautifully Graced LLC

  • Health & Wellness Coach
  • Palm Bay, FL
  • NPI 1811617863
  NPD Authorized official

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

{
    "created_epoch": "1621382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704931200000",
    "number": "1962076331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2155 PALM BAY RD NE STE 7",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329052907",
            "telephone_number": "321-220-0862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2155 PALM BAY RD NE STE 7",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329052907",
            "telephone_number": "321-220-0862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JERNIGHAN",
        "first_name": "STEPHANIE",
        "middle_name": "D",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-05-19",
        "last_updated": "2024-01-11",
        "certification_date": "2024-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171400000X",
            "taxonomy_group": "",
            "desc": "Health & Wellness Coach",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeanty'Scare Transportation LLC
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• Jeffrey T Obrien MD Inc
• Larra Jensen, HCHI, HD
• Jeroll Care Assisted Living, LLC
• Jeroll Care Assisted Living, LLC
• Chartavis Jerry
• Rebecca Jeudi
• Gladysbel Jimenez

• Developmental Therapist in Palm Bay, FL
• Providers in Palm Bay, FL by specialty
• Developmental Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2024; 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.