Individual provider Active NPI

Jenna Elizabeth Frost, PA-C

  • Physician Assistant
  • Fort Moore, GA
National Provider Identifier
1033590203
Registry record updated Dec 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
Martin Army Community Hospital
6600 Van Aalst Blvd BLDG 9250
Fort Moore, GA 31905
Phone
(706) 544-9516
NPI assigned
Jun 14, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

Martin Army Community Hospital
6600 Van Aalst Blvd BLDG 9250
Fort Moore, GA 31905

Mailing address

6600 Van Aalst Blvd BLDG 9250
Fort Moore, GA 31905-2102

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Pic Wisconsin SC CurrentSince Jul 10, 2023 Accepting new patients
Phoebe Physician Group, Inc PastSince Jun 1, 2021 Accepting new patients

Locations

19165 W Bluemound Rd
Brookfield, WI 53045
Phone (847) 653-0130

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1434240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702857600000",
    "number": "1033590203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6600 VAN AALST BLVD BLDG 9250",
            "city": "FORT MOORE",
            "state": "GA",
            "postal_code": "319052102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MARTIN ARMY COMMUNITY HOSPITAL",
            "address_2": "6600 VAN AALST BLVD BLDG 9250",
            "city": "FORT MOORE",
            "state": "GA",
            "postal_code": "31905",
            "telephone_number": "706-544-9516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FROST",
        "first_name": "JENNA",
        "middle_name": "ELIZABETH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-14",
        "last_updated": "2023-12-18",
        "certification_date": "2023-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Moore, GA

Sources for this page

Verify at the official NPI Registry.