Individual provider Active NPI

Charay Jennings-Dover, M.D., PH.D.

  • Dermatopathology (Pathology) Physician
  • Smyrna, GA
National Provider Identifier
1114282076
Registry record updated Apr 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatopathology (Pathology) PhysicianTaxonomy code 207ZD0900X
License
A109084 Issued in CA
Practice address
2000 Lake Park Dr SE
Smyrna, GA 30080-7611
Phone
(678) 556-9411
NPI assigned
Jul 6, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatopathology (Pathology) Physician 207ZD0900X A109084 CA Primary

Addresses

Primary practice location

2000 Lake Park Dr SE
Smyrna, GA 30080-7611

Mailing address

PO Box 23329
New York, NY 10087-3329

Other practice location 1

305 Park Creek Dr
Clovis, CA 93611-4426
Phone (559) 326-2800

Other names 1

  • Dr. Charay D Jennings 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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210521000450 GA Practitioner - Pathology 5890944052 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Stanford University School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Skinpath Solutions Inc.Group PAC ID 7315070489, 3 clinicians

Practice addresses (Care Compare)

2000 Lake Park Dr SE
Smyrna, GA 30080-7611
Phone (678) 556-9411

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A109084CAMDDermatopathology (Pathology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Podpath, Inc Dermatopathology CurrentSince Jun 1, 2021 Accepting new patients
Skinpath Solutions, Inc Dermatopathology CurrentSince Jun 1, 2021 Accepting new patients

Locations

1125 Troupe St
Augusta, GA 30904
Phone (706) 738-7977

2000 Lake Park Dr SE
Smyrna, GA 30080
Phone (678) 556-9411

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": "1341532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776038400000",
    "number": "1114282076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23329",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100873329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 LAKE PARK DR SE",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300807611",
            "telephone_number": "678-556-9411"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "305 Park Creek Dr",
            "address_purpose": "LOCATION",
            "city": "Clovis",
            "state": "CA",
            "postal_code": "936114426",
            "country_code": "US",
            "telephone_number": "559-326-2800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JENNINGS-DOVER",
        "first_name": "CHARAY",
        "name_prefix": "Dr.",
        "credential": "M.D., PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-06",
        "last_updated": "2026-04-13",
        "certification_date": "2026-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZD0900X",
            "taxonomy_group": "",
            "desc": "Pathology, Dermatopathology",
            "state": "CA",
            "license": "A109084",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHARAY",
            "last_name": "JENNINGS",
            "middle_name": "D",
            "prefix": "DR.",
            "credential": "M.D., PH.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Smyrna, GA

Sources for this page

Verify at the official NPI Registry.