Individual provider Active NPI

Jennifer Laura Wyatt, NP

  • Family Nurse Practitioner
  • Athens, GA
National Provider Identifier
1376241737
Registry record updated Oct 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN198700 Issued in GA
Practice address
1010 Prince Ave Ste 300
Athens, GA 30606-5805
Phone
(706) 425-1470
NPI assigned
Feb 15, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN198700 GA Primary

Addresses

Primary practice location

1010 Prince Ave Ste 300
Athens, GA 30606-5805

Mailing address

1010 Prince Ave Ste 300
Athens, GA 30606-5805
Phone (706) 425-1470

Other practice location 1

3320 Old Jefferson Rd Bldg 700
Athens, GA 30607-1465
Phone (706) 353-2990

Other practice location 2

355 Clear Creek Pkwy Ste 2007
Lavonia, GA 30553-4271
Phone (706) 356-2934

Other practice location 3

119 Harmony Xing Ste 1
Eatonton, GA 31024-9571
Phone (706) 353-2990

Other names 1

  • Jennifer C Wyatt Other name

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
I20230502001123 GA Practitioner - Nurse Practitioner 6709241458 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Piedmont Athens Specialty Care LLCGroup PAC ID 8820349772, 116 clinicians

Practice addresses (Care Compare)

1199 Prince Ave
Athens, GA 30606-2797
Phone (706) 475-1700

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.62 of 100Reported as apm
Quality
83.25
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN198700GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Piedmont Athens Specialty Care LLC CurrentSince Oct 1, 2023 Accepting new patients

Locations

1199 Prince Ave
Athens, GA 30606
Phone (706) 354-3520

3320 Old Jefferson Rd
Bldg 700
Athens, GA 30607
Phone (706) 224-6348

340 Exchange Blvd
Bethlehem, GA 30620
Phone (678) 963-7171

Organizations & group practices 1

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1676419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698624000000",
    "number": "1376241737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 PRINCE AVE STE 300",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306065805",
            "telephone_number": "706-425-1470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 PRINCE AVE STE 300",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306065805",
            "telephone_number": "706-425-1470"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3320 Old Jefferson Rd Bldg 700",
            "address_purpose": "LOCATION",
            "city": "Athens",
            "state": "GA",
            "postal_code": "306071465",
            "country_code": "US",
            "telephone_number": "706-353-2990",
            "fax_number": "706-353-2992",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "355 Clear Creek Pkwy Ste 2007",
            "address_purpose": "LOCATION",
            "city": "Lavonia",
            "state": "GA",
            "postal_code": "305534271",
            "country_code": "US",
            "telephone_number": "706-356-2934",
            "fax_number": "706-356-4713",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "119 Harmony Xing Ste 1",
            "address_purpose": "LOCATION",
            "city": "Eatonton",
            "state": "GA",
            "postal_code": "310249571",
            "country_code": "US",
            "telephone_number": "706-353-2990",
            "fax_number": "706-353-2992",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WYATT",
        "first_name": "JENNIFER",
        "middle_name": "LAURA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-15",
        "last_updated": "2023-10-30",
        "certification_date": "2023-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN198700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "WYATT",
            "middle_name": "C",
            "credential": "NP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Athens, GA

Sources for this page

Verify at the official NPI Registry.