Individual provider Active NPI

Joanna Jarrell, NP

  • Pediatric Nurse Practitioner
  • Macon, GA
National Provider Identifier
1376008110
Registry record updated Sep 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
RN204712 Issued in GA
Practice address
1062 Forsyth St Ste 2E
Macon, GA 31201-8631
Phone
(478) 633-7330
Fax
(478) 633-7630
NPI assigned
Feb 6, 2019
Last updated
Sep 16, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X RN204712 GA Primary

Addresses

Primary practice location

1062 Forsyth St Ste 2E
Macon, GA 31201-8631

Mailing address

1062 Forsyth St Ste 2E
Macon, GA 31201-8631
Phone (478) 633-7330

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
I20190320001767 GA Practitioner - Nurse Practitioner 3577803097 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Health Services of Central Georgia, Inc CurrentSince Mar 1, 2019 Accepting new patients
Hospital Authority of the City of Bainbridge and Decatur County Past Accepting new patients

Locations

1062 Forsyth St
Ste 2E
Macon, GA 31201
Phone (478) 633-7330

722 1st St
Macon, GA 31201
Phone (478) 257-8290

1120 Morningside Dr
Perry, GA 31069
Phone (478) 218-1706

Interoperability endpoints

  • Direct secure messaging: jjarrell433643@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1549411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600214400000",
    "number": "1376008110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1062 FORSYTH ST STE 2E",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312018631",
            "telephone_number": "478-633-7330",
            "fax_number": "478-633-7360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1062 FORSYTH ST STE 2E",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312018631",
            "telephone_number": "478-633-7330",
            "fax_number": "478-633-7630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JARRELL",
        "first_name": "JOANNA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-06",
        "last_updated": "2020-09-16",
        "certification_date": "2020-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "GA",
            "license": "RN204712",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Macon, GA

Sources for this page

Verify at the official NPI Registry.