Individual provider Active NPI

Jenny Prinsell, NP-C

  • Family Nurse Practitioner
  • Columbus, GA
National Provider Identifier
1114383973
Registry record updated Jan 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN200680 Issued in GA
Practice address
7351 Old Moon Rd
Columbus, GA 31909-7291
Phone
(706) 653-7000
Fax
(706) 653-7800
NPI assigned
Jan 11, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2016

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 RN200680 GA Primary

Addresses

Primary practice location

7351 Old Moon Rd
Columbus, GA 31909-7291

Mailing address

7351 Old Moon Rd
Columbus, GA 31909-7291
Phone (706) 653-7000

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
I20160128000865 GA Practitioner - Nurse Practitioner 9032412887 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northside Surgical Professional Services LLCGroup PAC ID 8628253424, 367 clinicians

Practice addresses (Care Compare)

470 Northside Cherokee Blvd
Suite 375
Canton, GA 30115-8029
Phone (770) 277-4277

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN200680GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Northside Surgical Professional Services LLC CurrentSince Nov 1, 2024 Accepting new patients

Locations

470 Northside Cherokee Blvd
Ste 375
Canton, GA 30115
Phone (770) 422-0444

1000 Johnson Fy Rd NE
Sandy Springs, GA 30342
Phone (404) 851-1000

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1452470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452470400000",
    "number": "1114383973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7351 OLD MOON RD",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319097291",
            "telephone_number": "706-653-7000",
            "fax_number": "706-653-7800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7351 OLD MOON RD",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319097291",
            "telephone_number": "706-653-7000",
            "fax_number": "706-653-7800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRINSELL",
        "first_name": "JENNY",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-11",
        "last_updated": "2016-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN200680",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, GA

Sources for this page

Verify at the official NPI Registry.