NPIMap

Individual provider Active NPI

Jennifer B. Cobernus, D.O.

  • Family Medicine Physician
  • Dacula, GA
National Provider Identifier
1184079196
Registry record updated Jan 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
82467 Issued in GA
Practice address
852 Dacula Rd
Dacula, GA 30019
Phone
(770) 848-9360
NPI assigned
Apr 27, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X 82467 GA Primary

Addresses

Primary practice location

852 Dacula Rd
Dacula, GA 30019

Mailing address

PO Box 742616
Atlanta, GA 30374-2616
Phone (770) 219-8420

Other practice location 1

1505 W Sherman Ave
Vineland, NJ 08360-7059
Phone (856) 641-8000

Other names 1

  • Jennifer L. Bosch Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jcobernus100320@nghs.gadirect.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190517002016 GA Practitioner - Family Practice 1254681372 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Philadelphia College of Osteopathic Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Northeast Georgia Physicians Group IncGroup PAC ID 6901898386, 884 clinicians

Practice addresses (Care Compare)

852 Dacula Rd
Dacula, GA 30019-3185
Phone (770) 848-9360

Hospital & facility affiliations

  • Central Home Health Care, an Amedisys Company Home health agency, Tucker, GA, CCN 117026
  • Northeast Georgia Medical Center, Inc Hospital, Gainesville, GA, CCN 110029
  • Northside Hospital Gwinnett Hospital, Lawrenceville, GA, CCN 110087
  • NGMC Barrow, LLC Hospital, Winder, GA, CCN 110045

Merit-based Incentive Payment System (MIPS)

Final score
88.16 of 100Reported as group
Quality
85.71
Promoting interoperability
100
Improvement activities
40
Cost
74.81

Merit-based Incentive Payment System (MIPS)

Final score
87.83 of 100Reported as group
Quality
80.36
Promoting interoperability
100
Improvement activities
40
Cost
79.08

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
82467GAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Georgia Physicians Group Urgent Care LLC Family Medicine CurrentSince May 1, 2019 Accepting new patients
Northeast Georgia Physicians Group Inc Family Medicine CurrentSince May 1, 2019 Accepting new patients
Inspira Health Network Medical Group, P.C. Past Accepting new patients

Locations

1515 River Pl
Ste 100
Braselton, GA 30517
Phone (770) 848-6195

852 Dacula Rd
Dacula, GA 30019
Phone (770) 848-9360

597 S Enota Dr NE
Gainesville, GA 30501
Phone (770) 219-8275

Interoperability endpoints

  • Direct secure messaging: jcobernus100320@nghs.gadirect.net

Organizations & group practices 4

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 4

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": "1461715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609718400000",
    "number": "1184079196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 742616",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303742616",
            "telephone_number": "770-219-8420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "852 DACULA RD",
            "city": "DACULA",
            "state": "GA",
            "postal_code": "30019",
            "telephone_number": "770-848-9360"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1505 W Sherman Ave",
            "address_purpose": "LOCATION",
            "city": "Vineland",
            "state": "NJ",
            "postal_code": "083607059",
            "country_code": "US",
            "telephone_number": "856-641-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COBERNUS",
        "first_name": "JENNIFER",
        "middle_name": "B.",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-27",
        "last_updated": "2021-01-04",
        "certification_date": "2021-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "82467",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jcobernus100320@nghs.gadirect.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "852 Dacula Rd",
            "city": "Dacula",
            "state": "GA",
            "country_code": "US",
            "postal_code": "30019",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "BOSCH",
            "middle_name": "L.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Dacula, GA

Sources for this page

Verify at the official NPI Registry.