Individual provider Active NPI

Laura Jennings, ARNP

  • General Practice Physician
  • St Petersburg, FL
National Provider Identifier
1972182046
Registry record updated Apr 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
11012551 Issued in FL
Practice address
4711 20TH St N
St Petersburg, FL 33714-3309
Phone
(172) 756-0687
NPI assigned
Apr 6, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 11012551 FL Primary

Addresses

Primary practice location

4711 20TH St N
St Petersburg, FL 33714-3309

Mailing address

4711 20TH St N
St Petersburg, FL 33714-3309
Phone (172) 756-0687

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
I20210629001343 FL Practitioner - Nurse Practitioner 9830590868 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Unique Healthcare Systems, LLCGroup PAC ID 5496058422, 39 clinicians

Practice addresses (Care Compare)

7101 US Hwy 19 N
Pinellas Park, FL 33781-4607
Phone (727) 201-8585

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11012551FLMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Unique Healthcare Systems LLC CurrentSince Apr 1, 2024 Accepting new patients
Unique Management Group PastSince Apr 1, 2024 Accepting new patients

Locations

7101 US Highway 19 N
Pinellas Park, FL 33781
Phone (727) 201-8585

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": "1617667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617667200000",
    "number": "1972182046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4711 20TH ST N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337143309",
            "telephone_number": "172-756-0687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4711 20TH ST N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337143309",
            "telephone_number": "172-756-0687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENNINGS",
        "first_name": "LAURA",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-06",
        "last_updated": "2021-04-06",
        "certification_date": "2021-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "11012551",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

Verify at the official NPI Registry.