Jennifer Erin Millsap, PHYSICIANS ASSISTANT

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

7861 Issued in GA

Practice address

415 E Crossville Rd
Roswell, GA 30075-7626

Phone

(770) 642-4644

Fax

(478) 328-0438

NPI assigned

Jun 22, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Miss Jennifer Erin Shapiro Former name

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

Specialty

Physician Assistant

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Georgia Dermatology and Skin Cancer Center, LLCGroup PAC ID 7113980855, 53 clinicians

Cleaver Medical Group Dermatology IncGroup PAC ID 7315276045, 13 clinicians

Practice addresses (Care Compare)

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.

• Cleaver Medical Group Dermatology Inc

  • Dermatology Physician
  • Cumming, GA
  • NPI 1841852076
  Medicare reassignment Care Compare group NPD
• Georgia Dermatology & Skin Cancer Center, LLC

  • Dermatology Physician
  • Dublin, GA
  • NPI 1063460459
  Medicare reassignment Care Compare group
• Georgia Dermatology &Skin Cancer Center, PC

  • Dermatology Physician
  • Macon, GA
  • NPI 1447363346
  NPD (past)

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

{
    "created_epoch": "1529625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592179200000",
    "number": "1265927230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 BELLEVUE RD STE 21A",
            "city": "DUBLIN",
            "state": "GA",
            "postal_code": "310212890",
            "telephone_number": "478-328-0281",
            "fax_number": "478-328-0438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 E CROSSVILLE RD",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300757626",
            "telephone_number": "770-642-4644",
            "fax_number": "478-328-0438"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3850 Pleasant Hill Rd",
            "address_purpose": "LOCATION",
            "city": "Duluth",
            "state": "GA",
            "postal_code": "300964807",
            "country_code": "US",
            "telephone_number": "770-814-8222 x238",
            "fax_number": "770-418-9530",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILLSAP",
        "first_name": "JENNIFER",
        "middle_name": "ERIN",
        "name_prefix": "Mrs.",
        "credential": "PHYSICIANS ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-22",
        "last_updated": "2020-06-15",
        "certification_date": "2020-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "8836",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "GA",
            "license": "7861",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "SHAPIRO",
            "middle_name": "ERIN",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Scott D Miller, M.D.
• Todd D Miller, M.D.
• Adrienne Millis, LPC
• Anthony Dwayne Mills, M.D.
• Jonathan Mills
• Milton Speech Pathology
• Milton Speech Pathology, LLC
• Madison Allen Mims, WHNP-BC
• Julie Kay Miner, PT
• Kristie L Miner

• Dermatology Physician in Roswell, GA
• Providers in Roswell, GA by specialty
• Dermatology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.