Alicia M Jennings, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

061901 Issued in GA

Practice address

101 Quartz Drive
Suite 201
Villa Rica, GA 30180

Phone

(770) 456-3839

Fax

(770) 456-3846

NPI assigned

Apr 11, 2006

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Internal Medicine

Education

Wayne State University School of Medicine, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Tanner Medical Group IncGroup PAC ID 2769536143, 120 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Tanner Home Health Services Home health agency, Carrollton, GA, CCN 117319
• Central Home Health Care, an Amedisys Company Home health agency, Douglasville, GA, CCN 117050
• Tanner Medical Center Villa Rica Hospital, Villa Rica, GA, CCN 110015
• Wellstar Douglas Medical Center Hospital, Douglasville, GA, CCN 110184
• Tanner Medical Center - Carrollton Hospital, Carrollton, GA, CCN 110011
• Wellstar Cobb Medical Center Hospital, Austell, GA, CCN 110143

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Tanner Medical Group Inc

  • Cardiovascular Disease Physician
  • Carrollton, GA
  • NPI 1396979787

  Internal Medicine

  Medicare reassignment Care Compare group NPD
• TMC Children'S Healthcare of West Georgia

  • Medical Specialty Clinic/Center
  • Carrollton, GA
  • NPI 1518972348
  NPD (past)
• Lake Mi Mobile Doctors P.C.

  • Geriatric Medicine (Internal Medicine) Physician
  • Austin, TX
  • NPI 1982962924
  NPD (past)
• Wayne County Therapeutic, Inc.

  • Medical Physician Assistant
  • Livonia, MI
  • NPI 1760533699

  Internal Medicine

  NPD (past)

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

• Amedisys Georgia, LLC

  • Home Health Agency
  • Douglasville, GA
  • NPI 1437117090
  Care Compare affiliation
• Cobb Hospital, Inc

  • General Acute Care Hospital
  • Austell, GA
  • NPI 1467420448
  Care Compare affiliation
• Douglas Hospital, Inc.

  • General Acute Care Hospital
  • Douglasville, GA
  • NPI 1649247974
  Care Compare affiliation
• Tanner Medical Center, Inc

  • General Acute Care Hospital
  • Carrollton, GA
  • NPI 1801883780
  Care Compare affiliation
• TMC Home Health Inc

  • Home Health Agency
  • Carrollton, GA
  • NPI 1457376386
  Care Compare affiliation
• TMC/Villa Rica Hospital, Inc

  • General Acute Care Hospital
  • Villa Rica, GA
  • NPI 1851388748
  Care Compare affiliation

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

{
    "created_epoch": "1144713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1366405037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 AMBULANCE DR STE 202",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301173857",
            "telephone_number": "770-838-8710",
            "fax_number": "770-838-8563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 QUARTZ DRIVE",
            "address_2": "SUITE 201",
            "city": "VILLA RICA",
            "state": "GA",
            "postal_code": "30180",
            "telephone_number": "770-456-3839",
            "fax_number": "770-456-3846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENNINGS",
        "first_name": "ALICIA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-11",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "061901",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "673576429C",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Deborah Jean Jahnke, APNP
• Mujeeb A Jan, MD
• Mardeea Jartu, LPC
• Stannetta Shonnae Jefferson, MED
• Jennifer Poole OD and Associates
• Michelae Jennings
• Lynette Jensen, M.ED., CCC-SLP
• Farah Jiwani, DMD
• Elissaveta B Johnson, M. S., R.D., L.D.
• La-Vonnie Joiner, PMHNP

• Internal Medicine Physician in Villa Rica, GA
• Providers in Villa Rica, GA by specialty
• Internal Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.