Individual provider Active NPI

Jennifer M Paschal, NP

  • Nurse Practitioner
  • Douglasville, GA
National Provider Identifier
1306077011
Registry record updated Jul 29, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN 192294 Issued in GA
Practice address
8954 Hospital Dr
Douglasville, GA 30134-2272
Phone
(770) 920-6426
NPI assigned
Jul 29, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN 192294 GA Primary

Addresses

Primary practice location

8954 Hospital Dr
Douglasville, GA 30134-2272

Mailing address

5665 New Northside Dr NW
Suite 320
Atlanta, GA 30328-5831
Phone (770) 874-5400

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
I20091203000721 GA Practitioner - Nurse Practitioner 1052450012 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Allatoona Emergency Group PCGroup PAC ID 2567847684, 26 clinicians

Practice addresses (Care Compare)

960 Joe Frank Harris Pkwy SE
Cartersville, GA 30120-2129
Phone (770) 382-1530

Merit-based Incentive Payment System (MIPS)

Final score
90.94 of 100Reported as group
Quality
83.37
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN 192294GAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Bortolazzo Group, LLC CurrentSince Oct 1, 2009 Accepting new patients
Acs Primary Care Physicians - Southeast PC Nurse Practitioner CurrentSince Dec 1, 2012 Accepting new patients
Allatoona Emergency Group PC Nurse Practitioner CurrentSince Aug 22, 2022 Accepting new patients
Lavender Inpatient Services LLC Past Accepting new patients
Mount Lassen Emergency Physicians LLC Past Accepting new patients

Locations

3950 Austell Rd
Austell, GA 30106
Phone (770) 732-3752

960 Joe Frank Harris Pkwy SE
Cartersville, GA 30120
Phone (404) 554-2196

8954 Hospital Dr
Douglasville, GA 30134
Phone (678) 838-2584

101 Lake Oconee Pkwy
Eatonton, GA 31024
Phone (706) 485-0907

2151 W Spring St
Monroe, GA 30655
Phone (770) 267-1792

5665 New Northside Dr
Ste 320
Sandy Springs, GA 30328
Phone (770) 874-5468

1700 Medical Way
Snellville, GA 30078
Phone (770) 978-4229

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1248825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1248825600000",
    "number": "1306077011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5665 NEW NORTHSIDE DR NW",
            "address_2": "SUITE 320",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303285831",
            "telephone_number": "770-874-5400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8954 HOSPITAL DR",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301342272",
            "telephone_number": "770-920-6426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PASCHAL",
        "first_name": "JENNIFER",
        "middle_name": "M",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-29",
        "last_updated": "2009-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN 192294",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Douglasville, GA

Sources for this page

Verify at the official NPI Registry.