Individual provider Active NPI

Janice C Matthewson, MD

  • Family Medicine Physician
  • Jonesboro, GA
National Provider Identifier
1245398478
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
014288 Issued in GA
Practice address
2400 Mount Zion Parkway
Family Practice Health Care Team a
Jonesboro, GA 30236
Phone
(770) 603-3649
NPI assigned
Dec 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 014288 GA Primary

Addresses

Primary practice location

2400 Mount Zion Parkway
Family Practice Health Care Team a
Jonesboro, GA 30236

Mailing address

3495 Piedmont Road NE
Nine Piedmont Center
Atlanta, GA 30305-9775
Phone (404) 364-7000

Other names 1

  • Janice Conchitta Burnett Other 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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171024003209 GA Order and Referring Only - Family PracticePractitioner - Family Practice 8224224340

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1245398478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3495 PIEDMONT ROAD NE",
            "address_2": "NINE PIEDMONT CENTER",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303059775",
            "telephone_number": "404-364-7000",
            "fax_number": "404-364-4732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 MOUNT ZION PARKWAY",
            "address_2": "FAMILY PRACTICE HEALTH CARE TEAM A",
            "city": "JONESBORO",
            "state": "GA",
            "postal_code": "30236",
            "telephone_number": "770-603-3649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTHEWSON",
        "first_name": "JANICE",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "014288",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JANICE",
            "last_name": "BURNETT",
            "middle_name": "CONCHITTA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Jonesboro, GA

Sources for this page

Verify at the official NPI Registry.