Individual provider Active NPI

Jennah Logan Siegel, APRN

  • Family Nurse Practitioner
  • Fort Lauderdale, FL
National Provider Identifier
1972067437
Registry record updated Nov 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11001010 Issued in FL
Practice address
551 N Federal Hwy
Fort Lauderdale, FL 33301-2559
Phone
(954) 712-8860
NPI assigned
Jan 29, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 11001010 FL Primary

Addresses

Primary practice location

551 N Federal Hwy
Fort Lauderdale, FL 33301-2559

Mailing address

155 Isle of Venice Dr Apt 502
Fort Lauderdale, FL 33301-1464
Phone (954) 895-6627

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250114004069 FL Practitioner - Nurse Practitioner 7719415009 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11001010FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pophealthcare, LLC CurrentSince Nov 9, 2024 Accepting new patients
Pophealthcare, LLC Family CurrentSince Nov 9, 2024 Accepting new patients

Locations

10739 Deerwood Park Blvd
Ste 200
Jacksonville, FL 32256
Phone (615) 721-7024

113 Seaboard Ln
Ste 200B
Franklin, TN 37067
Phone (615) 721-7020

Interoperability endpoints

  • Direct secure messaging: jennah.siegel.1@29290.direct.athenahealth.com

Organizations & group practices 2

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": "1548720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572998400000",
    "number": "1972067437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 ISLE OF VENICE DR APT 502",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333011464",
            "telephone_number": "954-895-6627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "551 N FEDERAL HWY",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333012559",
            "telephone_number": "954-712-8860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIEGEL",
        "first_name": "JENNAH",
        "middle_name": "LOGAN",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-29",
        "last_updated": "2019-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11001010",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lauderdale, FL

Sources for this page

Verify at the official NPI Registry.