Individual provider Active NPI

Jennifer Oliver, FNP

  • Family Nurse Practitioner
  • Conyers, GA
National Provider Identifier
1225682602
Registry record updated Feb 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
256198 Issued in GA
Practice address
1810 Georgia Highway 20 SE Ste 172
Conyers, GA 30013-2001
Phone
(770) 679-9938
NPI assigned
Jul 24, 2019
Last updated
Feb 16, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 256198 GA Primary

Addresses

Primary practice location

1810 Georgia Highway 20 SE Ste 172
Conyers, GA 30013-2001

Mailing address

998 Hwy 19-41 PO Box 1342
Hampton, GA 30228-1837
Phone (980) 200-7958

Other practice location 1

421 Fayetteville St Ste 1100
Raleigh, NC 27601-3000
Phone (888) 731-8994

Other practice location 2

900 Old Roswell Lakes Pkwy Ste 310
Roswell, GA 30076-8667
Phone (888) 731-8994

Other practice location 3

111 N Orange Ave Ste 800
Orlando, FL 32801-2381
Phone (888) 731-8994

Other practice location 4

4254 W Orchid Ln
Chandler, AZ 85226-7246
Phone (888) 731-8994

Other practice location 5

139 Centre St Ph 120
New York, NY 10013-4559
Phone (888) 731-8994

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, FL, NC3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20200123003010 GA Practitioner - Nurse Practitioner 7719312545 Reassigns benefits to 3 organizations
I20250328003339 FL Practitioner - Nurse Practitioner 7719312545 Reassigns benefits to 1 organization
I20250425000298 NC Practitioner - Nurse Practitioner 7719312545 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
256198GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Minuteclinic LLC Family CurrentSince Sep 9, 2020 Accepting new patients
Copilotiq, PC CurrentSince Apr 14, 2025 Accepting new patients
Atlanta Medical Clinic L L C CurrentSince Nov 11, 2019 Accepting new patients
Copilotiq Medical PA Past Accepting new patients

Locations

6271 Saint Augustine Rd
Jacksonville, FL 32217
Phone (615) 412-8777

197 14th St NW
Ste 300
Atlanta, GA 30318
Phone (404) 872-8837

3343 Peachtree Rd NE
Atlanta, GA 30326
Phone (615) 412-8777

2 N Zack Hinton Pkwy
McDonough, GA 30253
Phone (770) 507-0576

11710 Alpharetta Hwy
Roswell, GA 30076
Phone (770) 754-0141

7207 Rockbridge Rd
Stone Mtn, GA 30087
Phone (770) 469-2002

3540 Toringdon Way
Ste 200
Charlotte, NC 28277
Phone (704) 575-7816

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/22351/brand/1/csg/1/fhir/r4

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, 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": "1563926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739664000000",
    "number": "1225682602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "998 HWY 19-41 PO BOX 1342",
            "city": "HAMPTON",
            "state": "GA",
            "postal_code": "302281837",
            "telephone_number": "980-200-7958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1810 GEORGIA HIGHWAY 20 SE STE 172",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300132001",
            "telephone_number": "770-679-9938"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "421 Fayetteville St Ste 1100",
            "address_purpose": "LOCATION",
            "city": "Raleigh",
            "state": "NC",
            "postal_code": "276013000",
            "country_code": "US",
            "telephone_number": "888-731-8994",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "900 Old Roswell Lakes Pkwy Ste 310",
            "address_purpose": "LOCATION",
            "city": "Roswell",
            "state": "GA",
            "postal_code": "300768667",
            "country_code": "US",
            "telephone_number": "888-731-8994",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "111 N Orange Ave Ste 800",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328012381",
            "country_code": "US",
            "telephone_number": "888-731-8994",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4254 W Orchid Ln",
            "address_purpose": "LOCATION",
            "city": "Chandler",
            "state": "AZ",
            "postal_code": "852267246",
            "country_code": "US",
            "telephone_number": "888-731-8994",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "139 Centre St Ph 120",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100134559",
            "country_code": "US",
            "telephone_number": "888-731-8994",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OLIVER",
        "first_name": "JENNIFER",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-24",
        "last_updated": "2025-02-16",
        "certification_date": "2025-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "256198",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conyers, GA

Sources for this page

Verify at the official NPI Registry.