Individual provider Active NPI

Tonya K Jefferson, APRN

  • Family Nurse Practitioner
  • Conyers, GA
National Provider Identifier
1073547600
Registry record updated Mar 31, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN157741 Issued in GA
Practice address
2890 Highway 212 SW Ste E
Conyers, GA 30094-3387
Phone
(770) 929-9150
NPI assigned
Jul 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN157741 GA Primary

Addresses

Primary practice location

2890 Highway 212 SW Ste E
Conyers, GA 30094-3387

Mailing address

2890 Highway 212 SW Ste E
Conyers, GA 30094-3387
Phone (770) 929-9150

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN157741GAMDFamily Nurse Practitioner

Interoperability endpoints

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

NPI Registry JSON

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427760000000",
    "number": "1073547600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2890 HIGHWAY 212 SW STE E",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300943387",
            "telephone_number": "770-929-9150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2890 HIGHWAY 212 SW STE E",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300943387",
            "telephone_number": "770-929-9150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEFFERSON",
        "first_name": "TONYA",
        "middle_name": "K",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-10",
        "last_updated": "2015-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN157741",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conyers, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 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.