Individual provider Active NPI

Jennifer Erin Dodd, AGACNP

  • Gerontology Nurse Practitioner
  • Gainesville, GA
National Provider Identifier
1285240580
Registry record updated Jan 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
RN235035 Issued in GA
Practice address
743 Spring St NE
Gainesville, GA 30501-3715
Phone
(770) 219-9000
NPI assigned
Sep 22, 2020
Last updated
Jan 28, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X RN235035 GA
Gerontology Nurse Practitioner 363LG0600X RN235035 GA Primary

Addresses

Primary practice location

743 Spring St NE
Gainesville, GA 30501-3715

Mailing address

PO Box 742616
Atlanta, GA 30374-2616
Phone (770) 219-8420

Other identifiers 1

IdentifierTypeStateIssuer
RN235035OtherGAGEORGIA BOARD OF NURSING

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jwood13713@nghs.gadirect.net Direct

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
I20201009000078 GA Practitioner - Nurse Practitioner 8729408968 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

743 Spring Nest
Gainesville, GA 30501-3715
Phone (770) 219-6000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.83 of 100Reported as group
Quality
80.36
Promoting interoperability
100
Improvement activities
40
Cost
79.08

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Georgia Physicians Group Inc CurrentSince Oct 1, 2020 Accepting new patients

Locations

597 S Enota Dr NE
Gainesville, GA 30501
Phone (770) 219-8275

743 Spring St NE
Gainesville, GA 30501
Phone (770) 219-5915

Organizations & group practices 1

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1600732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643328000000",
    "number": "1285240580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 742616",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303742616",
            "telephone_number": "770-219-8420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "743 SPRING ST NE",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013715",
            "telephone_number": "770-219-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DODD",
        "first_name": "JENNIFER",
        "middle_name": "ERIN",
        "name_prefix": "Mrs.",
        "credential": "AGACNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-22",
        "last_updated": "2022-01-28",
        "certification_date": "2022-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "GA",
            "license": "RN235035",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "GA",
            "license": "RN235035",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GEORGIA BOARD OF NURSING",
            "identifier": "RN235035",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jwood13713@nghs.gadirect.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "743 Spring St NE",
            "city": "Gainesville",
            "state": "GA",
            "country_code": "US",
            "postal_code": "305013715",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Gainesville, GA

Sources for this page

Verify at the official NPI Registry.