Individual provider Active NPI

Julia Prawl Ceglenski, MD

  • Family Medicine Physician
  • Jasper, GA
National Provider Identifier
1073263604
Registry record updated Aug 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
100224 Issued in GA
Practice address
175 Samaritan Dr
Jasper, GA 30143-1964
Phone
(706) 253-4633
NPI assigned
Mar 26, 2022
Last updated
Aug 12, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NC
Family Medicine Physician 207Q00000X 100224 GA Primary

Addresses

Primary practice location

175 Samaritan Dr
Jasper, GA 30143-1964

Mailing address

175 Samaritan Dr
Jasper, GA 30143-1964
Phone (706) 253-4633

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL Allscripts

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260523000299 GA Practitioner - Family Practice 0547640138 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Saint Louis University School of Medicine, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

175 Samaritan Dr
Jasper, GA 30143-1964

315 W Ponce de Leon Ave
Suite 1000
Decatur, GA 30030-2433

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
100224GAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Good Samaritan Health & Wellness Center Inc. CurrentSince Aug 17, 2025 Accepting new patients
Good Samaritan Health & Wellness Center Inc. CurrentSince Nov 9, 2025 Accepting new patients

Locations

175 Samaritan Dr
Jasper, GA 30143
Phone (706) 253-4633

Interoperability endpoints

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1648252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754956800000",
    "number": "1073263604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 SAMARITAN DR",
            "city": "JASPER",
            "state": "GA",
            "postal_code": "301431964",
            "telephone_number": "706-253-4633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 SAMARITAN DR",
            "city": "JASPER",
            "state": "GA",
            "postal_code": "301431964",
            "telephone_number": "706-253-4633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CEGLENSKI",
        "first_name": "JULIA",
        "middle_name": "PRAWL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-26",
        "last_updated": "2025-08-12",
        "certification_date": "2025-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NC",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "100224",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Allscripts",
            "affiliation": "N",
            "address_1": "123 Hendersonville Rd",
            "city": "Asheville",
            "state": "NC",
            "country_code": "US",
            "postal_code": "288032868",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Jasper, GA

Sources for this page

Verify at the official NPI Registry.