Individual provider Active NPI

Jeannot Junior Joseph

  • Student in an Organized Health Care Education/Training Program
  • Gainesville, GA
National Provider Identifier
1174463095
Registry record updated Mar 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
1439 Jesse Jewell Pkwy NE Ste 102
Gainesville, GA 30501-3806
Phone
(770) 219-9446
NPI assigned
Mar 31, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

1439 Jesse Jewell Pkwy NE Ste 102
Gainesville, GA 30501-3806

Mailing address

743 Spring St NE Ste 710
Gainesville, GA 30501-3715
Phone (770) 219-8730

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
I20260515003010 GA Order and Referring Only - Family PracticePractitioner - Family Practice 9436628773

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1774915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774915200000",
    "number": "1174463095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "743 SPRING ST NE STE 710",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013715",
            "telephone_number": "770-219-8730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1439 JESSE JEWELL PKWY NE STE 102",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013806",
            "telephone_number": "770-219-9446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOSEPH",
        "first_name": "JEANNOT",
        "middle_name": "JUNIOR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-03-31",
        "last_updated": "2026-03-31",
        "certification_date": "2026-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, GA

Sources for this page

Verify at the official NPI Registry.