Donna Faye Jennings, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

0110009697 Issued in VA

Practice address

9276 Old Keene Mill Rd
Burke, VA 22015-4201

Phone

(571) 516-3116

Fax

(571) 516-3070

NPI assigned

Nov 20, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Donna Faye Denton Former name

Medicare fee-for-service enrollment

Enrolled in GA, DC, VA3 enrollments

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 3

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Roanoke Valley Healthcare Partners, LLC

  • Multi-Specialty Clinic/Center
  • Roanoke, VA
  • NPI 1619274446

  DC

  Medicare reassignment
• Coweta Emergency Group LLC

  • Emergency Medicine Physician
  • Newnan, GA
  • NPI 1245556588
  Medicare reassignment
• Peachtree Immediate Care FP, LLC

  • Family Medicine Physician
  • Hiram, GA
  • NPI 1437194156
  Medicare reassignment
• Blue Ridge Healthcare Partners, LLC

  • Primary Care Clinic/Center
  • Roanoke, VA
  • NPI 1518304955
  NPD (past)
• Short Pump Family Care, LLC

  • Primary Care Clinic/Center
  • Midlothian, VA
  • NPI 1487068334
  NPD (past)
• GP Wellness Center, LLC

  • Internal Medicine Physician
  • Mableton, GA
  • NPI 1821462979
  NPD (past)

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

{
    "created_epoch": "1258675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719446400000",
    "number": "1144558669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9276 OLD KEENE MILL RD",
            "city": "BURKE",
            "state": "VA",
            "postal_code": "220154201",
            "telephone_number": "571-516-3116",
            "fax_number": "571-516-3070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9276 OLD KEENE MILL RD",
            "city": "BURKE",
            "state": "VA",
            "postal_code": "220154201",
            "telephone_number": "571-516-3116",
            "fax_number": "571-516-3070"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3901 Pine Lake Rd",
            "address_2": "Suite 120",
            "address_purpose": "LOCATION",
            "city": "Lincoln",
            "state": "NE",
            "postal_code": "685165497",
            "country_code": "US",
            "telephone_number": "402-420-1212",
            "fax_number": "402-328-0961",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JENNINGS",
        "first_name": "DONNA",
        "middle_name": "FAYE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-20",
        "last_updated": "2024-06-27",
        "certification_date": "2024-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NE",
            "license": "1471",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "VA",
            "license": "0110009697",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF NEBRASKA",
            "identifier": "01942 GROUP",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DONNA",
            "last_name": "DENTON",
            "middle_name": "FAYE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Farnaz Jabbari, DDS
• Jack a Merenda, Psy.D., Inc.
• Lina Jameel, DDS
• James L Gyuricza DDS PC
• Jeffrey I. Klioze, D.D.S., LTD
• Jessica Russo Revand, DMD, Ms, PLLC
• Kirti Johal, M.D.
• John-Mike Nelson, PLLC
• Angela Lynn John, OTR/L
• Elizabeth Johnson, PT, DPT

• Medical Physician Assistant in Burke, VA
• Providers in Burke, VA by specialty
• Medical Physician Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.