Jaclyn C. Collins, FNP
Individual provider Active NPI Family Nurse Practitioner · Young Harris, GA
NPI 1124424536 · NPPES record last updated Jan 16, 2019
Key facts
- NPI
- 1124424536
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- RN208019 (GA)
- Practice address
- 1155 Main St
Young Harris, GA 30582 - Phone
- (706) 439-6873
- Fax
- (706) 439-6874
- NPI assigned
- Nov 12, 2014
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 11
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Privia Medical Group of Georgia LLC
Practice addresses (Care Compare)
101 Yorktown Dr
Fayetteville, GA 30214-1578
101 Yorktown Dr
Suite 100
Fayetteville, GA 30214-7663
Phone (770) 460-4285
123 A-2 Weaver Rd
Blairsville, GA 30512-3155
Phone (706) 400-8675
5934 Hwy 515 E
Blairsville, GA 30512-3272
Phone (706) 970-4599
Hospital & facility affiliations
- Mountain Home Health
- Union General Hospital
- Erlanger Murphy Medical Center
- Chatuge Regional Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150427000968 | GA | Practitioner - Nurse Practitioner | 0345569232 | Reassigns benefits to 4 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Union County Hospital Authority | Current | Accepting new patients | |
| Hillcrest Clinic, LLC | Current |
Accepting new patients | |
| Privia Medical Group of Georgia LLC | Current |
Accepting new patients | |
| Chatuge Regional Hospital Inc | Current | Accepting new patients | |
| Union County Hospital Authority | Current |
Accepting new patients | |
| Chatuge Regional Hospital Inc | Current |
Accepting new patients | |
| Trinity Primary Care LLC | Current | Accepting new patients | |
| Union County Hospital Authority | Current |
Accepting new patients | |
| Privia Medical Group of Georgia LLC | Current |
Accepting new patients | |
| Chatuge Regional Hospital Inc | Past | Accepting new patients | |
| Wendy L Smith M.D. PC | Past | Accepting new patients |
Locations
35 Hospital Rd
Blairsville, GA 30512
Phone (706) 439-6812
123 Weaver Rd
#A
Blairsville, GA 30512
Phone (706) 745-9417
401 Pat Haralson Dr
Unit 1
Blairsville, GA 30512
Phone (706) 745-8790
101 Yorktown Dr
Ste 100
Fayetteville, GA 30214
Phone (770) 460-4285
110 S Main St
Hiawassee, GA 30546
Phone (706) 896-2222
1155 Main St
Young Harris, GA 30582
Phone (706) 439-6873
Interoperability endpoints
- https://api.platform.athenahealth.com/8042/brand/1/csg/1/fhir/r4
- jaclyn.collins.1@8042.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | RN208019 | GA | Yes |
Addresses
Primary practice location
1155 Main St
Young Harris, GA 30582
Mailing address
35 Hospital Rd
Blairsville, GA 30512-3139
Phone (706) 745-2111
Other practice location 1
2257 Highway 515 W
Blairsville, GA 30512-3780
Phone (706) 439-6860
Other practice location 2
1155 Main St
Young Harris, GA 30582
Phone (706) 439-6873
Other practice location 3
77 Weaver Rd Ste B
Blairsville, GA 30512-3136
Phone (706) 439-6165
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 003161419A | Medicaid | GA | |
| 1124424536 | Medicaid | NC |
Other providers in Young Harris, GA
- Paula Jean Boyle
- Brasstown Internal Medicine Group
- Brooklane Therapy Services
- Halee Brown
- Deborah Lea Burrell
- Joseph Gratton Crockett III
- Sharman Louise Cunningham
- Hanah Lauren Curtis
- Stephen Andrew Dockery
- Kathleen Claire Duncanson
All providers in Young Harris, GA · Family Nurse Practitioner in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 16, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.