Individual provider Active NPI

Jodie J Salo, ANP

  • Adult Health Nurse Practitioner
  • Buford, GA
National Provider Identifier
1215078902
Registry record updated May 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
RN128795 Issued in GA
Practice address
135 Slate Dr
Buford, GA 30518-1664
Phone
(678) 634-2894
NPI assigned
Feb 8, 2007
Last updated
May 22, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X RN128795 GA Primary

Addresses

Primary practice location

135 Slate Dr
Buford, GA 30518-1664

Mailing address

135 Slate Dr
Buford, GA 30518-1664
Phone (678) 634-2894

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
I20180510002579 GA Practitioner - Nurse Practitioner 8224355268 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Georgia Mso LLC CurrentSince Apr 15, 2025 Accepting new patients
Hardy Renew Wellness,LLC CurrentSince May 1, 2024 Accepting new patients
Greater Gwinnett Physician Practice Company Past Accepting new patients

Locations

1640 Powers Ferry Rd SE
Bldg 15
Marietta, GA 30067
Phone (770) 722-9595

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716336000000",
    "number": "1215078902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 SLATE DR",
            "city": "BUFORD",
            "state": "GA",
            "postal_code": "305181664",
            "telephone_number": "678-634-2894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 SLATE DR",
            "city": "BUFORD",
            "state": "GA",
            "postal_code": "305181664",
            "telephone_number": "678-634-2894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALO",
        "first_name": "JODIE",
        "middle_name": "J",
        "credential": "ANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-08",
        "last_updated": "2024-05-22",
        "certification_date": "2024-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "GA",
            "license": "RN128795",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buford, GA

Sources for this page

Verify at the official NPI Registry.