MRS. JENNIFER DERONVILLE STANLEY – Adult Health Nurse Practitioner, NPI 1902679889

MRS. JENNIFER DERONVILLE STANLEY is a healthcare provider. based in Fort lauderdale, Florida. specializing in NURSE PRACTITIONER. They hold a License No. 9460025 (FL). The NPI Number for MRS. JENNIFER DERONVILLE STANLEY is 1902679889

Main info

Female
3 Years Of Experience
Accepts Medicare Assignment
Name
MRS. JENNIFER DERONVILLE STANLEY
NPI
1902679889
Phone
Not provided
Address
2920 NW 25TH ST
Enumeration Date
2 November 2023
Last Update Date
2 November 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9545784000
Graduation Year
2023 (3 years ago)
PAC ID
2264977156
Group Practice PAC ID
0244261683
Professional Enrollment ID
I20240716001606
Address ID
FL330671538PA6093XTERX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience37
Completeness75
Years active:2State licenses:2Digital endpointsOther names

24,232 NURSE PRACTITIONER in FL

Provider Addresses for MRS. JENNIFER DERONVILLE STANLEY

  • 2920 NW 25TH ST

    FORT LAUDERDALE, FL 333112836

    Phone:

    Type: Mailing

  • 777 GLADES RD

    BOCA RATON, FL 334316424

    Phone: (561) 297-3000

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-07-16

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240716001606INurse PractitionerFLTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 33311)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0244261683View full group profile
NameSpecialtyState
-FL
Nurse PractitionerFL
Internal MedicineFL
Nurse PractitionerGA
-FL
Nurse PractitionerFL
Nurse PractitionerFL
Interventional Pain ManagementFL
Nurse PractitionerFL
-FL

Reviews

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Frequently asked questions

What NPI should I save for MRS. JENNIFER DERONVILLE STANLEY?
Save NPI 1902679889 if you need a stable reference for MRS. JENNIFER DERONVILLE STANLEY.
Is MRS. JENNIFER DERONVILLE STANLEY's enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
What does MRS. JENNIFER DERONVILLE STANLEY treat or focus on?
Patients typically see MRS. JENNIFER DERONVILLE STANLEY under the specialty Adult Health Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Where is MRS. JENNIFER DERONVILLE STANLEY's primary listing?
We display Fort Lauderdale, Florida because that is what the record indicates for MRS. JENNIFER DERONVILLE STANLEY.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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