Individual provider Active NPI

Jenifer D. Nobles, PAAA

  • Anesthesiologist Assistant
  • Phenix City, AL
National Provider Identifier
1154318285
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiologist AssistantTaxonomy code 367H00000X
License
AA-831 Issued in AL
Practice address
4401 River Chase Dr
Phenix City, AL 36867-7483
Phone
(334) 732-3000
NPI assigned
Oct 4, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiologist Assistant 367H00000X 2569 GA
Anesthesiologist Assistant 367H00000X AA-831 AL Primary

Addresses

Primary practice location

4401 River Chase Dr
Phenix City, AL 36867-7483

Mailing address

PO Box 235022
Montgomery, AL 36123-5022
Phone (334) 396-6930

Other identifiers 1

IdentifierTypeStateIssuer
515-38482OtherALBCBS OF AL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041021000385 GA Practitioner - Anesthesiology Assistant 2668433889 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology Assistant
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Piedmont Anesthesia LLCGroup PAC ID 2163837972, 555 clinicians

Practice addresses (Care Compare)

1133 Eagles Landing Pkwy
Stockbridge, GA 30281-5085
Phone (800) 242-1131

Hospital & facility affiliations

  • Piedmont Henry Hospital Hospital, Stockbridge, GA, CCN 110191

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Associate of Arts

State licenses

LicenseStateTypeSpecialty
AA-831ALMDAnesthesiologist Assistant
2569GAMDAnesthesiologist Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Piedmont Anesthesia LLC CurrentSince Mar 13, 2023 Accepting new patients
Orthomed Staffing LLC CurrentSince May 1, 2021 Accepting new patients

Locations

400 Charter Blvd
Macon, GA 31210
Phone (478) 757-6000

380 Hospital Dr
Ste 380
Macon, GA 31217
Phone (478) 746-5644

1133 Eagles Landing Pkwy
Stockbridge, GA 30281
Phone (678) 604-1000

135 N Park Pl
Ste 100
Stockbridge, GA 30281
Phone (256) 438-8160

830 Eagles Landing Pkwy
Ste 101
Stockbridge, GA 30281
Phone (402) 779-6135

Organizations & group practices 3

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 1

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": "1128384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1154318285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 235022",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361235022",
            "telephone_number": "334-396-6930",
            "fax_number": "334-396-6929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4401 RIVER CHASE DR",
            "city": "PHENIX CITY",
            "state": "AL",
            "postal_code": "368677483",
            "telephone_number": "334-732-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOBLES",
        "first_name": "JENIFER",
        "middle_name": "D.",
        "credential": "PAAA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "GA",
            "license": "2569",
            "primary": false
        },
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "AL",
            "license": "AA-831",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF AL",
            "identifier": "515-38482",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phenix City, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.