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MRS. NICOLE BLACKWELL JENNINGS PA-C
NPI 1730290990
Physician Assistant in Fort Worth, TX

Active since August 31, 2006PECOS Enrolled
1500 COOPER ST, FORT WORTH, TX 76104(682) 885-2500(682) 885-2510 Get Directions Write a Review

NPPES record last updated: May 18, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 18, 2021, Sep 11, 2020, Nov 14, 2018 (3 updates tracked since 2018).

About Mrs. Nicole Blackwell Jennings Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MRS. NICOLE BLACKWELL JENNINGS PA-C (NPI 1730290990) is an individual physician assistant in Fort Worth, Texas, licensed in Texas (PA04862) and active in the NPI registry since August 2006. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1730290990
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameMRS. NICOLE BLACKWELL JENNINGSCredential: PA-C
Location Address1500 COOPER STFort Worth, TX 76104-2710
Mailing AddressPo Box 733784Dallas, TX 75373-3784 · (682) 885-6163 · Fax (682) 885-1396
Phone(682) 885-2500
Fax(682) 885-2510
Sole ProprietorNo
Enumeration DateAugust 31, 2006
Last NPPES UpdateMay 18, 20213 updates tracked since enumeration
NPPES CertifiedMay 18, 2021
✔ NPI 1730290990 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in TX · PA04862
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
Also ListedPhysician Assistant · MedicalTaxonomy 363AM0700X · License PA04862 (TX)
1500 COOPER ST, Fort Worth, TX 76104
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Other Names 1

Former Name (1)Miss Nicole Lea Blackwell Pa-c

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Imperial Insurance Companies, Inc..Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mrs. Nicole Blackwell Jennings Pa-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 76104 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$87.20 typical visit price
range $56.47 – $171.07
Typical copayment $21.80 (range $14.11 – $42.76)
Most-billed visit code 99203
Established Patient
$70.45 typical visit price
range $18.18 – $139.68
Typical copayment $17.61 (range $4.54 – $34.92)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KATRINA L WILLIE-MUSOMA MD
Pediatrics (Neurodevelopmental Disabilities)
1500 COOPER ST
FORT WORTH, TX 76104
Tarrant County (682) 303-9300
SCHARLYN R HENDERSON LCSW
Social Worker (Clinical)
1500 COOPER ST
FORT WORTH, TX 76104
Tarrant County (682) 885-1475
GREGORY BARKER
Pediatrics (Pediatric Cardiology)
1500 COOPER ST
FORT WORTH, TX 76104
Tarrant County (682) 885-2140
DR. ELORA PATTANAIK CORBIN M.D.
Psychiatry & Neurology (Neurology with Special Qualifications in Child Neurology)
1500 COOPER ST
FORT WORTH, TX 76104
Tarrant County (682) 885-2500
SHANE KELLEHER PA-C
Physician Assistant
1500 COOPER ST
FORT WORTH, TX 76104
Tarrant County (682) 885-7840
BENJAMIN CRAIG PA-C
Physician Assistant
1500 COOPER ST
FORT WORTH, TX 76104
Tarrant County (682) 885-2500
DR. SHAILENDRA DAS D.O.
Pediatrics (Pediatric Pulmonology)
1500 COOPER ST
FORT WORTH, TX 76104
Tarrant County (682) 885-6299
JAMES C CUNNINGHAM MD
Pediatrics (Pediatric Pulmonology)
1500 COOPER ST
FORT WORTH, TX 76104
Tarrant County (682) 885-6299

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Nicole Jennings's NPI number?

The NPI number for Nicole Jennings is 1730290990. It was assigned to this individual provider in the NPPES registry on August 31, 2006. The provider is also known as Miss Nicole Lea Blackwell Pa-C.

Where is Nicole Jennings located?

Nicole Jennings practices at 1500 Cooper St, Fort Worth, TX 76104. The listed phone number is (682) 885-2500.

What is Nicole Jennings's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Nicole Jennings enrolled in Medicare?

Yes. Nicole Jennings is registered in the Medicare PECOS enrollment system.

What insurance does Nicole Jennings accept?

Health plans from Imperial Insurance Companies, Inc. list Nicole Jennings as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Nicole Jennings was last updated on May 18, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.