Active NPI
Jacquelyn Paynter
- Family Nurse Practitioner
- Conyers, GA
National Provider Identifier
1194279398
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- RN204761
- Practice address
- 2796 Highway 20 SE
Conyers, GA 30013-2735 - Phone
- (678) 374-5134
- NPI assigned
- Aug 5, 2016
- Last updated
- Aug 10, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | RN204761 | GA | Primary |
Addresses
Primary practice location
2796 Highway 20 SE
Conyers, GA 30013-2735
Mailing address
5674 Southcrest LN
Lithonia, GA 30038-6132
Phone (770) 685-1712
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN204761 | GA | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sonquest Development, Inc. | Past | Accepting new patients | |
| Piedmont Providers LLC | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Attain Health
- Health Service Clinic/Center
- Conyers, GA
- NPI 1356792501
-
- Internal Medicine Physician
- Jasper, GA
- NPI 1548273592
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1470355200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1470787200000",
"number": "1194279398",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5674 SOUTHCREST LN",
"city": "LITHONIA",
"state": "GA",
"postal_code": "300386132",
"telephone_number": "770-685-1712"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2796 HIGHWAY 20 SE",
"city": "CONYERS",
"state": "GA",
"postal_code": "300132735",
"telephone_number": "678-374-5134"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAYNTER",
"first_name": "JACQUELYN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-08-05",
"last_updated": "2016-08-10",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "GA",
"license": "RN204761",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Conyers, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.