Organization Active NPI

Jasmine Jeffers, MD, LLC

Doing business as Westside Medical Associates

  • Gastroenterology Physician
  • Austell, GA
National Provider Identifier
1366586422
Registry record updated Jul 16, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
Legal business name
JASMINE JEFFERS, MD, LLC
Doing business as
Westside Medical Associates
Practice address
3825 Medical Park Dr
Suite 300
Austell, GA 30106-1109
Phone
(770) 941-4810
Fax
(770) 948-9149
NPI assigned
Feb 20, 2007
Last updated
Jul 16, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2007

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

Authorized official

Name
Mr. Devon Charles Spencer
Title
Practice Manager
Phone
(770) 941-4810

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X Primary

Addresses

Primary practice location

3825 Medical Park Dr
Suite 300
Austell, GA 30106-1109

Mailing address

PO Box 650
Austell, GA 30168-1007
Phone (770) 941-4810

Other names 1

  • Westside Medical Associates Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040109000710 GA Part B Supplier - Clinic/Group Practice 5193625887 Receives reassigned benefits from 1 practitioner
Practice locations: Austell, GA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D0975645Jasmine Jeffers MD LLC, Westside Med Assoc3825 Medical Park Drive, Suite 300, Austell, GA 30106Certificate of waiverApr 17, 2027

National Provider Directory

National Provider Directory

Locations

6095 Professional Pkwy
Ste B203
Douglasville, GA 30134
Phone (770) 947-7747

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184544000000",
    "number": "1366586422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 650",
            "city": "AUSTELL",
            "state": "GA",
            "postal_code": "301681007",
            "telephone_number": "770-941-4810",
            "fax_number": "770-948-9149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3825 MEDICAL PARK DR",
            "address_2": "SUITE 300",
            "city": "AUSTELL",
            "state": "GA",
            "postal_code": "301061109",
            "telephone_number": "770-941-4810",
            "fax_number": "770-948-9149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JASMINE JEFFERS, MD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-20",
        "last_updated": "2007-07-16",
        "status": "A",
        "authorized_official_last_name": "SPENCER",
        "authorized_official_first_name": "DEVON",
        "authorized_official_middle_name": "CHARLES",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "770-941-4810",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Westside Medical Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Austell, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.