Jismaria Antony
Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Warner Robins, GA
NPI 1396581815 · NPPES record last updated Jul 25, 2024
Key facts
- NPI
- 1396581815
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Student in an Organized Health Care Education/Training Program 390200000X
- License
- 16648 (GA)
- Practice address
- 1601 Watson Blvd
Warner Robins, GA 31093-3431 - Phone
- (478) 975-6880
- NPI assigned
- Jul 3, 2024
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240724003477 | GA | Order and Referring Only - Family Practice |
4385180413 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | 16648 | GA | Yes |
Addresses
Primary practice location
1601 Watson Blvd
Warner Robins, GA 31093-3431
Mailing address
1601 Watson Blvd
Warner Robins, GA 31093-3431
Phone (478) 975-6880
Other practice location 1
233 N Houston Rd Ste 140E
Warner Robins, GA 31093-3023
Phone (478) 975-6880
Other providers in Warner Robins, GA
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- Angels of Health LLC
- Ellie Angley
- Chiamaka Joyce Anosike
- Oneidge Yhanna Anthony
- Applecare, LLC
- Jessica Arceneaux
- Armin Inc
- Kenyona Armstrong
- Sheryl Denise Armstrong
All providers in Warner Robins, GA · Student in an Organized Health Care Education/Training Program in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 25, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.