Individual provider Active NPI

Jeanie Harper

  • Dental Hygienist
  • Fitzgerald, GA
National Provider Identifier
1073676573
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
License
6067 Issued in GA
Practice address
171 Perry House Rd
PO Drawer 1009
Fitzgerald, GA 31750-8837
Phone
(229) 423-9237
NPI assigned
Dec 18, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Hygienist 124Q00000X 6067 GA Primary

Addresses

Primary practice location

171 Perry House Rd
PO Drawer 1009
Fitzgerald, GA 31750-8837

Mailing address

171 Perry House Rd
PO Drawer 1009
Fitzgerald, GA 31750-8837
Phone (229) 423-9237

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
6067GAMDDental Hygienist

Practice roles

OrganizationSpecialtyStatusNew patients
Wayne S. Maris, DDS, PC Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1073676573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "171 PERRY HOUSE RD",
            "address_2": "PO DRAWER 1009",
            "city": "FITZGERALD",
            "state": "GA",
            "postal_code": "317508837",
            "telephone_number": "229-423-9237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "171 PERRY HOUSE RD",
            "address_2": "PO DRAWER 1009",
            "city": "FITZGERALD",
            "state": "GA",
            "postal_code": "317508837",
            "telephone_number": "229-423-9237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARPER",
        "first_name": "JEANIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "GA",
            "license": "6067",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fitzgerald, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.