Individual provider Active NPI

Jennifer Smith Thompson, FNP

  • Nurse Practitioner
  • Jackson, GA
National Provider Identifier
1386801900
Registry record updated May 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN142971 Issued in GA
Practice address
1502 W 3Rd St
Jackson, GA 30233-1979
Phone
(678) 774-0430
Fax
(770) 775-3410
NPI assigned
May 21, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN142971 GA Primary

Addresses

Primary practice location

1502 W 3Rd St
Jackson, GA 30233-1979

Mailing address

1502 W 3Rd St
Jackson, GA 30233-1979
Phone (678) 774-0430

Other identifiers 1

IdentifierTypeStateIssuer
235074233AMedicaidGA

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
I20080624000473 GA Practitioner - Nurse Practitioner 6002987773 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aylo Health, LLCGroup PAC ID 8022901925, 112 clinicians

Practice addresses (Care Compare)

1100 Hospital Dr
Stockbridge, GA 30281-6381
Phone (770) 914-0116

1108 Hospital Dr
Stockbridge, GA 30281-6381
Phone (770) 914-0116

145 Eagles Walk
Suite a
Stockbridge, GA 30281-7340
Phone (770) 914-0116

1502 W 3Rd St
Suite a
Jackson, GA 30233-1979
Phone (770) 914-0116

3758 Hwy 42
Locust Grove, GA 30248-3653
Phone (770) 914-0116

3758 Hwy 42 S
Locust Grove, GA 30248-3653
Phone (770) 914-0116

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN142971GAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Aylo Health, LLC CurrentSince Apr 1, 2010 Accepting new patients
Aylo Health, LLC CurrentSince Apr 1, 2010 Accepting new patients
Aylo Health, LLC Past Accepting new patients
Aylo Health, LLC Past Accepting new patients
Aylo Health, LLC Past Accepting new patients

Locations

1502 W 3rd St
Jackson, GA 30233
Phone (678) 248-2899

1502 W 3rd St
Ste A
Jackson, GA 30233
Phone (678) 774-0430

2330 Patrick Henry Pkwy
Ste 200
McDonough, GA 30253

145 Eagles Walk
Ste A
Stockbridge, GA 30281
Phone (770) 389-3855

Interoperability endpoints

  • Direct secure messaging: jennifer.thompson@elfp.eclinicaldirectplus.com

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1211328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430784000000",
    "number": "1386801900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1502 W 3RD ST",
            "city": "JACKSON",
            "state": "GA",
            "postal_code": "302331979",
            "telephone_number": "678-774-0430",
            "fax_number": "770-775-3410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1502 W 3RD ST",
            "city": "JACKSON",
            "state": "GA",
            "postal_code": "302331979",
            "telephone_number": "678-774-0430",
            "fax_number": "770-775-3410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "JENNIFER",
        "middle_name": "SMITH",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-21",
        "last_updated": "2015-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN142971",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "235074233A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, GA

Sources for this page

Verify at the official NPI Registry.