Jennifer O'Donnell, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

008697 Issued in GA

Practice address

2701 N Decatur Rd
Decatur, GA 30033-5918

Phone

(404) 501-1000

NPI assigned

Jan 4, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Cep America LLC

  • Emergency Medicine Physician
  • Lithonia, GA
  • NPI 1124073721

  GA

  Medicare reassignment
• Acs Primary Care Physicians - Southeast PC

  • Emergency Medicine Physician
  • Myrtle Beach, SC
  • NPI 1861430555

  GA

  Medicare reassignment
• Cep America LLC

  • Emergency Medicine Physician
  • Decatur, GA
  • NPI 1215982814
  NPD
• Cep America LLC

  • Emergency Medicine Physician
  • Fort Lauderdale, FL
  • NPI 1700747946
  NPD
• Lavender Inpatient Services LLC

  • Internal Medicine Physician
  • Cartersville, GA
  • NPI 1902215767
  NPD (past)
• Mount Lassen Emergency Physicians LLC

  • Emergency Medicine Physician
  • Cartersville, GA
  • NPI 1730598590
  NPD (past)

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

{
    "created_epoch": "1515024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540339200000",
    "number": "1255848859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2701 N DECATUR RD",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300335918",
            "telephone_number": "404-501-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 N DECATUR RD",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300335918",
            "telephone_number": "404-501-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2801 Dekalb Medical Pkwy",
            "address_purpose": "LOCATION",
            "city": "Lithonia",
            "state": "GA",
            "postal_code": "300584996",
            "country_code": "US",
            "telephone_number": "404-501-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "O'DONNELL",
        "first_name": "JENNIFER",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-04",
        "last_updated": "2018-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "008697",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patrick William O'Carroll, MD, MPH
• Patricia O'Connell, PH.D.
• Aidan Anne O'Connor
• Mary-Catherine O'Connor, CRNA
• Siobhan O'Connor, M.D.
• Kathleen Therese O'Donnell, M.D
• Kyle A O'Donnell, RPA-C
• Maureen O'Donnell
• Maria O'Farrell, OTR/L
• Katherine O'Lone, LCSW

• All providers in Decatur, GA
• Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.