Jill M Antisell, CNM

Primary specialty

MidwifeTaxonomy code 176B00000X

License

RN164801 Issued in GA

Practice address

550 Peachtree St NE Ste 1275
Atlanta, GA 30308-2240

Phone

(404) 872-3121

Fax

(404) 872-3119

NPI assigned

Jan 23, 2007

Last updated

May 20, 2024By the provider in NPPES

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 3

Other names 1

• Jill M Antisell Former name

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Midwife, Certified Registered Nurse

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/BAJJAD/Endpoint/BAJJAD

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

• Northside Hospital, Inc.

  dba Northside Hospital Gwinnett

  • General Acute Care Hospital
  • Lawrenceville, GA
  • NPI 1952340994
  Medicare reassignment NPD
• Atlanta Perinatal Associates

  • Maternal & Fetal Medicine Physician
  • Atlanta, GA
  • NPI 1104973064
  NPD
• Gwinnett Medical Group, Inc

  • General Practice Physician
  • Lawrenceville, GA
  • NPI 1780747469
  NPD
• Gwinnett Pathology Assoc PC

  • Anatomic Pathology & Clinical Pathology Physician
  • Lawrenceville, GA
  • NPI 1104887330
  NPD
• Northside Hospital, Inc.

  dba Northside Hospital Duluth

  • General Acute Care Hospital
  • Duluth, GA
  • NPI 1790715381
  NPD
• Pagemed, LLC

  • Maternal & Fetal Medicine Physician
  • Macon, GA
  • NPI 1619274180
  NPD (past)

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716163200000",
    "number": "1013061043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3495 PIEDMONT ROAD, NE",
            "address_2": "NINE PIEDMONT CENTER",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30305",
            "telephone_number": "404-364-7070",
            "fax_number": "470-325-0193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 PEACHTREE ST NE STE 1275",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303082240",
            "telephone_number": "404-872-3121",
            "fax_number": "404-872-3119"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3650 Steve Reynolds Blvd",
            "address_2": "Kaiser Permanente Gwinnett Comprehensive Medical Center",
            "address_purpose": "LOCATION",
            "city": "Duluth",
            "state": "GA",
            "postal_code": "30096",
            "country_code": "US",
            "telephone_number": "770-931-6012",
            "fax_number": "678-377-5284",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANTISELL",
        "first_name": "JILL",
        "middle_name": "M",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-23",
        "last_updated": "2024-05-20",
        "certification_date": "2024-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "176B00000X",
            "taxonomy_group": "",
            "desc": "Midwife",
            "state": "GA",
            "license": "RN164801",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PEACH STATE",
            "identifier": "285718185A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "285718185A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "285718185A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JILL",
            "last_name": "ANTISELL",
            "middle_name": "M",
            "credential": "CNM",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Charmaine Simone Anthony, APRN, BC
• Lauren Elizabeth Anthony, PA-C
• Megan Anthony, ATC
• Anthos Integrative Psychotherapy, LLC
• Anti-Aging Queen, Inc
• Andreya Nicole Marie Antoine
• Patrick Antoine, M.D.
• Sethley Branan Antonelli, M.S., CCC-SLP
• Antonio Rios Crna PC
• Nikoleta Antoniou Karademitrou, MA

• Midwife in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Midwife in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.