Individual provider Active NPI

Jennifer Miller Rafus, M.S., FNP, LIC. AC.

  • Family Nurse Practitioner
  • Waycross, GA
National Provider Identifier
1114007630
Registry record updated Jan 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN235259 Issued in GA
Practice address
615A Pendleton St
Waycross, GA 31501-4724
Phone
(912) 548-0710
NPI assigned
Oct 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X RN235259 GA
Family Nurse Practitioner 363LF0000X RN235259 GA Primary

Addresses

Primary practice location

615A Pendleton St
Waycross, GA 31501-4724

Mailing address

615A Pendleton St
Waycross, GA 31501-4724
Phone (912) 548-0710

Other names 1

  • Jennifer Miller Perry Former name

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151020001759 GA Practitioner - Nurse Practitioner 1456330240 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
89.64 of 100Reported as group
Quality
92.57
Improvement activities
40
Cost
75.37

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Satilla Rheumatology and Internal Medicine, PC CurrentSince Feb 1, 2018 Accepting new patients
Memorial Satilla Specialists, LLC CurrentSince May 1, 2017 Accepting new patients
Mayo Clinic Health System in Waycross, Inc. CurrentSince Jun 1, 2015 Accepting new patients
Integrated Regional Laboratories Pathology Services, LLC Current Accepting new patients
Lahey Clinic, Inc. Past Accepting new patients
Lahey Clinic, Inc Past Accepting new patients
Mass General Brigham Medical Group Northern Massachusetts Inc PastSince May 1, 2015 Accepting new patients

Locations

223 Bay St
Baxley, GA 31513
Phone (912) 548-0710

316 Shirley Ave
Douglas, GA 31533
Phone (912) 383-0815

615 Pendleton St
Ste A
Waycross, GA 31501
Phone (912) 548-0710

1921 Alice St
Ste 4B
Waycross, GA 31501
Phone (912) 285-5690

Interoperability endpoints

  • Direct secure messaging: jennifer.rafus.p1@direct.satillarheum.nextgenshare.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • FHIR API: https://fhir4.healow.com/fhir/r4/DGICDD/Endpoint/DGICDD

Organizations & group practices 7

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": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516579200000",
    "number": "1114007630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615A PENDLETON ST",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "315014724",
            "telephone_number": "912-548-0710",
            "fax_number": "912-548-0071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615A PENDLETON ST",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "315014724",
            "telephone_number": "912-548-0710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAFUS",
        "first_name": "JENNIFER",
        "middle_name": "MILLER",
        "name_prefix": "Mrs.",
        "credential": "M.S., FNP, LIC. AC.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-17",
        "last_updated": "2018-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "GA",
            "license": "RN235259",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN235259",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "PERRY",
            "middle_name": "MILLER",
            "credential": "M.S.FNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Waycross, GA

Sources for this page

Verify at the official NPI Registry.