JENNA BROOKE PUGH (FNP) – Family Nurse Practitioner, NPI 1124660063
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
22,209 NURSE PRACTITIONER in TX
Provider Addresses for JENNA BROOKE PUGH (FNP)
325 N Saint Paul St Ste 3100
Dallas, TX 752013923
Phone: (888) 731-8994
Type: Location
111 N Orange Ave Ste 800
Orlando, FL 328012381
Phone: (888) 731-8994
Type: Location
999 18th St Ste 3000
Denver, CO 802022449
Phone: (888) 731-8994
Type: Location
County Road, Carrollton, Carroll County, Missouri, 64633, United States
CARROLLTON, MS 389175731
Phone:
Type: Mailing
317 E CAPITOL ST STE 200
JACKSON, MS 392013405
Phone: (888) 731-8994
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $15.
Total Amount is formed as General ($15) + Research ($0) + Ownership ($0) = $15.
Last reported payment date: 2023-10-26 • Largest payer in this snapshot: GlaxoSmithKline, LLC. ($15).
Total Amount
$15
General + Research + Ownership
Payments
1
Total payment records
General Amount
$15
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-10-26
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| GlaxoSmithKline, LLC. | $15 |
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: 2019-12-12
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20191212002109 | I | Nurse Practitioner | MS | TBD |
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.
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 75201)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | MS | |
| Family Practice | MD | |
| Family Practice | AR | |
| - | MS | |
| Nurse Practitioner | MS | |
| Nurse Practitioner | MS | |
| Nurse Practitioner | MS | |
| O B S T E T R I C S/ G Y N E C O L O G Y | MS | |
| Nurse Practitioner | MS | |
| - | MS |
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