Jennica Marlee Miner

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

104167604405 Issued in UT

Practice address

620 S 400 E Ste 404
St George, UT 84770-7065

Phone

(435) 656-8918

NPI assigned

Mar 8, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Jennica Marlee Gardner Professional name

Medicare fee-for-service enrollment

Enrolled in OR

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

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Nisha Jackson IncGroup PAC ID 6305147745, 47 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sky Lakes Medical Center Hospital, Klamath Falls, OR, CCN 380050
• Lake District Hospital Hospital, Lakeview, OR, CCN 381309

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: jennica.gardnerfnp.p1@direct.opm.nextgenshare.com

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.

• Nisha Jackson PC

  • Nurse Practitioner
  • Medford, OR
  • NPI 1124499124
  Medicare reassignment Care Compare group
• Metro Treatment of Utah LP

  • Methadone Clinic
  • St George, UT
  • NPI 1700092236
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Lake Health District

  • Critical Access Hospital
  • Lakeview, OR
  • NPI 1376698522
  Care Compare affiliation
• Sky Lakes Medical Center Inc

  • Occupational Therapist
  • Klamath Falls, OR
  • NPI 1134270911

  Hospital

  Care Compare affiliation
• Sky Lakes Medical Center Inc

  • General Acute Care Hospital
  • Klamath Falls, OR
  • NPI 1659340370
  Care Compare affiliation

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

{
    "created_epoch": "1615161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689724800000",
    "number": "1982299301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "348 E 4500 S",
            "address_2": "STE 220",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841078524",
            "telephone_number": "801-577-7055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 S 400 E STE 404",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847707065",
            "telephone_number": "435-656-8918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINER",
        "first_name": "JENNICA",
        "middle_name": "MARLEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-08",
        "last_updated": "2023-07-19",
        "certification_date": "2023-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "104167604405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNICA",
            "last_name": "GARDNER",
            "middle_name": "MARLEE",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Wade Osmond Milne, LCSW
• Mind and Health Psychiatry
• Mindfully Fit Wellness and Psychiatry Services PLLC
• Danalee Miner
• Jared Todd Miner, MD, PHD
• Jens Miner
• John E Miner, MD
• Morgan Lee Miner
• McKale Nichole Minniear
• Seth Jacob Minton, DO

• Family Nurse Practitioner in St George, UT
• Providers in St George, UT by specialty
• Family Nurse Practitioner in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.