Individual provider Active NPI

Krishmaa Jendayi-Robinson, NURSE PRACTITIONER

  • Psychiatric/Mental Health Nurse Practitioner
  • Newnan, GA
National Provider Identifier
1184215923
Registry record updated Jul 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
249968 Issued in GA
Practice address
15 Perry St # 394
Newnan, GA 30263-1918
Phone
(678) 850-4807
NPI assigned
Feb 2, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 249968 GA Primary

Addresses

Primary practice location

15 Perry St # 394
Newnan, GA 30263-1918

Mailing address

15 Perry St # 394
Newnan, GA 30263-1918
Phone (678) 850-4807

Other names 1

  • Mrs. Krishmaa Jendayi Former name

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211102000210 GA Practitioner - Nurse Practitioner 8527456128 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
249968GAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Personal Recovery Network LLC CurrentSince Oct 8, 2021 Accepting new patients
Grow Healthcare Group PA Psychiatric/Mental Health CurrentSince Jul 23, 2024 Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

715 Peachtree St NE
Ste 100
Atlanta, GA 30308
Phone (202) 972-4964

250 Corporate Center Ct
Stockbridge, GA 30281
Phone (770) 954-8685

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1612224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689292800000",
    "number": "1184215923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 PERRY ST # 394",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302631918",
            "telephone_number": "678-850-4807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 PERRY ST # 394",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302631918",
            "telephone_number": "678-850-4807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENDAYI-ROBINSON",
        "first_name": "KRISHMAA",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-02",
        "last_updated": "2023-07-14",
        "certification_date": "2023-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "GA",
            "license": "249968",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISHMAA",
            "last_name": "JENDAYI",
            "prefix": "MRS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Newnan, GA

Sources for this page

Verify at the official NPI Registry.