Jeannie Leann Bain, CRNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

1-094402 Issued in AL

Practice address

1359 Old Water Works Rd SW
Fort Payne, AL 35968-3347

Phone

(256) 997-5900

NPI assigned

Mar 19, 2021

Last updated

Nov 5, 2021By the provider in NPPES

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 identifiers 2

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

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Fort Payne Pediatrics LLC

  • Rural Health Clinic/Center
  • Fort Payne, AL
  • NPI 1033477393

  Family

  NPD (past)

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

{
    "created_epoch": "1616112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636070400000",
    "number": "1992381164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 GALA ST",
            "city": "RAINSVILLE",
            "state": "AL",
            "postal_code": "359864477",
            "telephone_number": "256-996-9371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1359 OLD WATER WORKS RD SW",
            "city": "FORT PAYNE",
            "state": "AL",
            "postal_code": "359683347",
            "telephone_number": "256-997-5900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAIN",
        "first_name": "JEANNIE",
        "middle_name": "LEANN",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-19",
        "last_updated": "2021-11-05",
        "certification_date": "2021-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-094402",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NP LICENSE",
            "identifier": "1-094402",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RX",
            "identifier": "9521",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Scott Bradley Argo, M.D.
• Andrea Nicole Ashley
• David Allen Atchley, M.D.
• Sonya Elizabeth Austin, PHARMD
• Bart Mitchell Bailey, MD
• Bart Onis Barber, DO
• Kevin A Bass, CSFA
• Gilles Bastille, M.D.
• Jena Baugh, DMD
• BHC-Palmer Orthopaedics and Sports Medicine

• Family Nurse Practitioner in Fort Payne, AL
• Providers in Fort Payne, AL by specialty
• Family Nurse Practitioner in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.