JENNIFER MOODY (NPI# 1356777650) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356777650 |
| Entity Type | Individual |
| Full Name | JENNIFER MOODY |
| Credential | ARNP |
| Practice Address |
10080 Sw Innovation Way Ste 201 Port St Lucie FL 34987-2129 |
| Mailing Address |
Po Box 417 Stuart FL 34995-0417 |
| Practice Telephone | 7723443811 |
| Practice Fax Number | 7723443890 |
| Mailing Telephone | 7722235665 |
| Mailing Fax Number | 7722235646 |
| Enumeration Date | 2013-09-18 |
| Last Update Date | 2020-10-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | ARNP9241652 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1651 Se Tiffany Ave, Ste 102, Port St Lucie, FL 349527564 | 7723981824 | 7723352422 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093186272 | Jennifer Moody | Acupuncturist | 1532 Se Clinton St, Portland, OR 97202-1130 | 2015-10-13 |
| 1063942068 | Jennifer Moody | Pediatrics | 259 1st St, Mineola, NY 11501-3957 | 2017-06-13 |
| 1770901621 | Jennifer Pratt Moody | Physical Medicine & Rehabilitation | 1500 Blondell Ave, Bronx, NY 10461-2643 | 2014-03-28 |
| 1265798334 | Jennifer Moody | Counselor | 259 Parkers Mill Rd, Somerset, KY 42501-3152 | 2012-04-03 |
| 1497037147 | Jennifer Pope Moody | Registered Nurse | 2080 W Arlington Blvd Ste B, Greenville, NC 27834 | 2011-09-19 |
| Street Address |
10080 SW INNOVATION WAY STE 201 |
| City | PORT ST LUCIE |
| State | FL |
| Zip Code | 34987-2129 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992777338 | Purandath Lall | Surgery | 10080 Sw Innovation Way Ste 201, Port St Lucie, FL 34987-2129 | 2006-02-01 |
| 1629501911 | Lisai Zhang | Family Medicine | 10080 Sw Innovation Way Ste 201, Port St Lucie, FL 34987-2129 | 2017-04-04 |
| 1164801130 | Konstantin Alekseyenko | Family Medicine | 10080 Sw Innovation Way Ste 201, Port St Lucie, FL 34987-2129 | 2015-05-23 |
| 1720498470 | Josue Limage | Family Medicine | 10080 Sw Innovation Way Ste 201, Port St Lucie, FL 34987 | 2014-05-03 |
| 1639425986 | Kathie Kowalczyk | Psychiatry & Neurology | 10080 Sw Innovation Way Ste 201, Port St Lucie, FL 34987-2129 | 2012-07-24 |
| 1740543057 | Eric Williams Owings | Surgery | 10080 Sw Innovation Way Ste 201, Port St Lucie, FL 34987-2129 | 2012-06-21 |
| 1750672200 | Avneet Vig | Internal Medicine | 10080 Sw Innovation Way Ste 201, Port St Lucie, FL 34987-2129 | 2011-05-02 |
| 1669606109 | Juan C Bird | Internal Medicine | 10080 Sw Innovation Way Ste 201, Port St Lucie, FL 34987-2129 | 2009-05-13 |
| 1295796290 | Mona F Fakhry | Internal Medicine | 10080 Sw Innovation Way Ste 201, Port St Lucie, FL 34987-2129 | 2006-03-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093299604 | Karen Cecilia Wong Li James | Registered Nurse | 10024 Sw Glenbrook Drive, Port Saint Lucie, FL 34987 | 2018-09-19 |
| 1134646151 | B & T Diagnostics LLC | Clinical Medical Laboratory | 11350 Sw Village Pkwy Ste 323, Port Saint Lucie, FL 34987 | 2017-08-30 |
| 1538684048 | Transport With Care, LLC | Non-emergency Medical Transport (VAN) | 1850 Sw Our Ct, Port Saint Lucie, FL 34987 | 2017-08-04 |
| 1154859825 | True Path Diagnostics, LLC | Clinical Medical Laboratory | 11350 Sw Village Pkwy Ste 309, Port St Lucie, FL 34987 | 2017-05-25 |
| 1316326515 | Aleksey Alekseyenko | Family Medicine | Mhpg Primary Care @ Tradition Health Park II, 10080 Sw Innovation Way Suite 201, Port St Lucie, FL 34987 | 2015-05-21 |
| 1053658583 | Tameka Argo | Contractor | 7664 Germany Canal Road, Fort Pierce, FL 34987 | 2013-01-03 |
| 1780967976 | Mennette J Colon | Specialist/Technologist, Other | 1970 Sw Glendale St., Port Saint Lucie, FL 34987 | 2011-09-23 |
| 1366416257 | Cynthia A Dolan | Dermatology | 10080 Sw Innovation Way Ste 301, Port St Lucie, FL 34987 | 2006-02-15 |
| 1205829074 | Andres M Reyes | Internal Medicine | 10050 Nw Innovation Way, Suite 102, Port St Lucie, FL 34987 | 2005-08-26 |
| 1013296110 | Karen Lee Harris | Pharmacist | 11995 Sw Elsinore Dr, Port Saint Lucie, FL 34987-1907 | 2011-08-08 |
| Find all providers in zip 34987 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790386811 | Louise Lorraine Voltaire | Nurse Practitioner | 7728 Nw Greenspring St, Port St Lucie, FL 34987-3052 | 2020-11-04 |
| 1043823644 | Jose Ruben Aldo Dawson | Nurse Practitioner | 656 Sw Munjack Cv, Port St Lucie, FL 34986-4530 | 2020-08-25 |
| 1629533674 | Angela Renea Trodglen | Nurse Practitioner | 1801 Se Hillmoor Dr Ste C-207, Port St Lucie, FL 34952-7574 | 2019-02-04 |
| 1104381490 | Taisha Johnson | Nurse Practitioner | 1893 Sw Kimberly Ave, Port St Lucie, FL 34953-1020 | 2019-01-31 |
| 1659835437 | Mirlange Odies Fleuriot | Nurse Practitioner | 2242 Sw Newport Isles Blvd, Port St Lucie, FL 34953-4577 | 2019-01-25 |
| 1760959811 | Kim Czerwinski | Nurse Practitioner | 386 Se Cork Rd, Port St Lucie, FL 34984-6309 | 2018-10-26 |
| 1316453244 | Kathleen Anne Gribbon | Nurse Practitioner | 2518 Se Pineland Dr, Port St Lucie, FL 34952-8045 | 2017-12-14 |
| 1982121646 | Natasha Bienaime | Nurse Practitioner | 1018 Sw Facet Ave, Port St Lucie, FL 34953 | 2017-08-24 |
| 1760843304 | Tania Burey Mclean | Nurse Practitioner | 4182 Sw Baird St, Port St Lucie, FL 34953-3136 | 2016-03-09 |
| 1801264577 | Shelita Dunlap | Nurse Practitioner | 10023 S Us Highway 1 Ste A, Port St Lucie, FL 34952-5643 | 2015-09-10 |
| Find all providers in PORT ST LUCIE | ||||
| City | PORT ST LUCIE |
| Zip Code | 34987 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.