Jane Paulk, FNP-BC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

RN052908 Issued in GA

Practice address

116 Smith St
Tennille, GA 31089-1465

Phone

(478) 552-7384

Fax

(478) 864-1288

NPI assigned

Oct 24, 2006

Last updated

Feb 23, 2017By the provider in NPPES

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

Other identifiers 1

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

Nurse Practitioner

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Community Health Care Systems, Inc.

  dba Johnson County Center for Community Health

  • Federally Qualified Health Center (FQHC)
  • Wrightsville, GA
  • NPI 1932150422
  Medicare reassignment NPD
• Community Health Care Systems, Inc

  dba Community Health Care Systems Administration & Specialty Services

  • Federally Qualified Health Center (FQHC)
  • Sandersville, GA
  • NPI 1184515694
  NPD

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487808000000",
    "number": "1306920954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 371",
            "city": "WRIGHTSVILLE",
            "state": "GA",
            "postal_code": "310960371",
            "telephone_number": "478-864-3448",
            "fax_number": "478-864-1288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 SMITH ST",
            "city": "TENNILLE",
            "state": "GA",
            "postal_code": "310891465",
            "telephone_number": "478-552-7384",
            "fax_number": "478-864-1288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAULK",
        "first_name": "JANE",
        "name_prefix": "Miss",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-24",
        "last_updated": "2017-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN052908",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GEORGIA LICENSE",
            "identifier": "RN052908",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lisa G Lamar, CERTIFIEDHHHIDE
• Little Behaviors LLC
• Majestic Senior Living Tennille LLC (Majestic Senior Living Tennille)
• Stephanie T McBurrough, FNP-C
• Nicks Nemt
• Debbie Pierce Price
• Temeka Reese, LMSW
• Linda Faye Scott, CNA
• Imani Simmons
• Amy Therese Solen

• Nurse Practitioner in Tennille, GA
• Providers in Tennille, GA by specialty
• Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2017; 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.