PHILIP FRANK ALAIN JESSEN (NPI# 1871977173) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871977173 |
| Entity Type | Individual |
| Full Name | PHILIP FRANK ALAIN JESSEN |
| Credential | APRN |
| Practice Address |
1005 Mar Walt Drive Internal Medicine Department Fort Walton Beach FL 32547-6707 |
| Mailing Address |
1005 Mar Walt Drive Internal Medicine Fort Walton Beach FL 32547-6707 |
| Practice Telephone | 8508638202 |
| Practice Fax Number | 8508626148 |
| Mailing Telephone | 8508638202 |
| Mailing Fax Number | 8508626148 |
| Enumeration Date | 2015-07-16 |
| Last Update Date | 2020-09-25 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | APRN3175792 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 015293800 | 05 | |
| FL | BCBSFL | Y0S6Y | 01 |
| Street Address |
1005 MAR WALT DRIVE INTERNAL MEDICINE DEPARTMENT |
| City | FORT WALTON BEACH |
| State | FL |
| Zip Code | 32547-6707 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285628743 | Vincent Thomas Jones | Radiology | 1005 Mar Walt Drive, Radiology Department, Fort Walton Beach, FL 32547-6796 | 2005-09-09 |
| 1841765351 | Mallory Hope Maddox | Physician Assistant | 1005 Mar Walt Drive, Immediate Care Department, Fort Walton Beach, FL 32547-6707 | 2018-10-11 |
| 1598299141 | Gary James Tackling | Internal Medicine | 1005 Mar Walt Drive, Internal Medicine Department, Fort Walton Beach, FL 32547-6707 | 2017-04-19 |
| 1083162457 | Heather Lutz Shelton | Nurse Practitioner | 1005 Mar Walt Drive, Pediatric Department, Fort Walton Beach, FL 32547-6796 | 2016-09-14 |
| 1508313180 | Stacey Lynn Paradise | Nurse Practitioner | 1005 Mar Walt Drive, Care Coordination Department, Fort Walton Beach, FL 32547-6796 | 2016-09-01 |
| 1497105118 | Alison Harpring Colonna | Pediatrics | 1005 Mar Walt Drive, Pediatric Department, Fort Walton Beach, FL 32547-6707 | 2016-06-14 |
| 1871964502 | Dixie Lee Allen | Nurse Practitioner | 1005 Mar Walt Drive, Immediate Care Department, Fort Walton Beach, FL 32547-6707 | 2015-10-07 |
| 1922494657 | Christian Constance Blackwell | Nurse Practitioner | 1005 Mar Walt Drive, Internal Medicine Department, Fort Walton Beach, FL 32547-6707 | 2015-04-09 |
| 1184026254 | Elizabeth Gayle Anderson | Nurse Practitioner | 1005 Mar Walt Drive, Care Coordination Department, Fort Walton Beach, FL 32547-6796 | 2014-09-20 |
| 1396162657 | Gregory James Stepp | Family Medicine | 1005 Mar Walt Drive, Family Medicine Department, Fort Walton Beach, FL 32547 | 2014-03-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255944955 | Theresa Ann Morvay | Behavior Technician | 419 Racetrack Rd Ne, Fort Walton Beach, FL 32547 | 2020-08-24 |
| 1588295422 | Emily Ann Glossop | Nurse Practitioner | 930 Mar Walt Drive C, Fort Walton Beach, FL 32547 | 2020-01-29 |
| 1225669443 | Elizabeth Rogers Nagengast | Physician Assistant | 930 Mar Walt Drive, Unit C, Fort Walton Beach, FL 32547 | 2020-01-27 |
| 1497254791 | Carmen Alston | Nurse Practitioner | 930 Mar Walt Dr C, Fort Walton Beach, FL 32547 | 2018-02-02 |
| 1871004960 | Center for Neuropsychological Services Cns | Clinical Neuropsychologist | 1817 Lewis Turner Blvd, Fort Walton Beach, FL 32547 | 2017-10-17 |
| 1194235648 | Robin Wray | Speech-Language Pathologist | 930 Mar Walt Dr D, Fort Walton Beach, FL 32547 | 2017-10-10 |
| 1285007989 | Dynamic Pain & Wellness Pllc | Pain Medicine | 930 Marwalt Drive, Suite B and C, Fort Walton Beach, FL 32547 | 2015-11-04 |
| 1013392810 | Terry Abbott | Social Worker | 648 Overbrook Dr, Fort Walton Beach, FL 32547 | 2015-07-22 |
| 1083024673 | Emily Lohr | Physical Therapy Assistant | 2000 Principle Ln, Ft. Walton Beach, FL 32547 | 2014-05-05 |
| 1831526102 | Laurie Ann Schweppe | Nurse Practitioner | 1005 Mar Walt Drivve, Snf Hospitalist Department, Fort Walton Beach, FL 32547 | 2013-10-02 |
| Find all providers in zip 32547 | ||||
| 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 |
|---|---|---|---|---|
| 1386096436 | Courtney Truax | Nurse Practitioner | 514 Mary Esther Cut Off Nw # Esther, Fort Walton Beach, FL 32548-4047 | 2016-07-12 |
| 1992901482 | Erika Renee Ceranowski | Nurse Practitioner | 1000 Mar-walt Drive, Fort Walton Beach Medical Center Er, Fort Walton Beach, FL 32547-4217 | 2007-06-22 |
| 1174508915 | Kathy A. Wilson | Nurse Practitioner | 2010 Lewis Turner Blvd, Fort Walton Beach, FL 32547-1352 | 2005-12-14 |
| 1609861442 | Leigh Suzanne Saylor | Nurse Practitioner | 1032 Mar Walt Drive, Suite 210, Fort Walton Beach, FL 32547-6661 | 2005-09-19 |
| 1538778378 | Helena Sylvia Tavarez | Nurse Practitioner | 1000 Mar Walt Drive, Wwmc Intensivists Department, Fort Walton Beach, FL 32547-6708 | 2020-07-28 |
| 1346718442 | Hannah Beth Webster | Nurse Practitioner | 1000 Mar Walt Dr, Fort Walton Beach, FL 32547-6708 | 2018-11-06 |
| 1679060198 | Katherine Lois Stuart | Nurse Practitioner | 1106 Hospital Rd, Fort Walton Beach, FL 32547 | 2018-04-19 |
| 1467988220 | Katrina Pendleton Borner | Nurse Practitioner | 1005 Mar Walt Dr, Fort Walton Beach, FL 32547-6707 | 2017-05-11 |
| 1083162457 | Heather Lutz Shelton | Nurse Practitioner | 1005 Mar Walt Drive, Pediatric Department, Fort Walton Beach, FL 32547-6796 | 2016-09-14 |
| 1508313180 | Stacey Lynn Paradise | Nurse Practitioner | 1005 Mar Walt Drive, Care Coordination Department, Fort Walton Beach, FL 32547-6796 | 2016-09-01 |
| Find all providers in FORT WALTON BEACH | ||||
| City | FORT WALTON BEACH |
| Zip Code | 32547 |
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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.