Individual provider Active NPI

Jessica M Gonzalez, CRNP

  • Family Nurse Practitioner
  • Huntsville, AL
National Provider Identifier
1982143541
Registry record updated Feb 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1-131743 Issued in AL
Practice address
4715 Whitesburg Dr SE
Huntsville, AL 35802-1649
Phone
(256) 881-5151
Fax
(256) 880-3939
NPI assigned
Feb 15, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2024

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 1-131743 AL Primary

Addresses

Primary practice location

4715 Whitesburg Dr SE
Huntsville, AL 35802-1649

Mailing address

4715 Whitesburg Dr SE
Huntsville, AL 35802-1649
Phone (256) 881-5151

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20170810001090 AL Practitioner - Nurse Practitioner 0749565554 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sportsmed Orthopaedic SpecialistsGroup PAC ID 7214903723, 87 clinicians

Practice addresses (Care Compare)

4715 Whitesburg Dr SE
Huntsville, AL 35802-1649
Phone (256) 881-5151

Merit-based Incentive Payment System (MIPS)

Final score
89.66 of 100Reported as group
Quality
90
Promoting interoperability
94
Improvement activities
40
Cost
80.55

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1-131743ALMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sportsmed Orthopaedic Specialists, PC CurrentSince Feb 1, 2024 Accepting new patients
Total Sports Care, P.C. CurrentSince Apr 18, 2017 Accepting new patients
Sportsmed Orthopaedic Specialists CurrentSince Feb 1, 2024 Accepting new patients

Locations

22423 US Highway 72
Ste A
Athens, AL 35613
Phone (256) 230-9607

2506 Danville Rd SW
Ste 202
Decatur, AL 35603
Phone (256) 306-0800

4205 Balmoral Dr SW
Ste 200
Huntsville, AL 35801
Phone (256) 382-7767

4715 Whitesburg Dr SE
Huntsville, AL 35802
Phone (256) 319-8500

33 Hughes Rd
Madison, AL 35758
Phone (256) 319-9327

Organizations & group practices 3

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": "1487116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707264000000",
    "number": "1982143541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4715 WHITESBURG DR SE",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358021649",
            "telephone_number": "256-881-5151",
            "fax_number": "256-880-3939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4715 WHITESBURG DR SE",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358021649",
            "telephone_number": "256-881-5151",
            "fax_number": "256-880-3939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "JESSICA",
        "middle_name": "M",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-15",
        "last_updated": "2024-02-07",
        "certification_date": "2024-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-131743",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntsville, AL

Sources for this page

Verify at the official NPI Registry.