Lauren A Jernigan, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

006233 Issued in GA

Practice address

10 Market Square Way
Suite 100
Newnan, GA 30265

Phone

(678) 423-5560

Fax

(678) 423-5563

NPI assigned

Oct 31, 2011

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Vibrant Kids Pediatrics, LLC

  • Clinic/Center
  • Newnan, GA
  • NPI 1811241417
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1320019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438041600000",
    "number": "1003192436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 MARKET SQUARE WAY",
            "address_2": "SUITE 100",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302656078",
            "telephone_number": "678-423-5560",
            "fax_number": "678-423-5563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 MARKET SQUARE WAY",
            "address_2": "SUITE 100",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "30265",
            "telephone_number": "678-423-5560",
            "fax_number": "678-423-5563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JERNIGAN",
        "first_name": "LAUREN",
        "middle_name": "A",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-31",
        "last_updated": "2015-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": "006233",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003119030",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003119030B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kelley Dawn Jenkins, PMHNP-BC
• Sarah Aileen Jennings-Kumagai, MD
• Melinda Emery Jennings, NP-C
• Thomas B. Jennings Jr., MS, LPC
• Erin Elizabeth Jerger, RD, CDE
• Kelley Jerris, MOTR/L
• Melanie Lynn Jessel, L.P.C.
• Jennifer L Jestel, APRN
• Sarah Ann Jett, NP-C
• Mike W Jin, DMD

• Medical Physician Assistant in Newnan, GA
• Providers in Newnan, GA by specialty
• Medical Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.