Individual provider Active NPI

Jodi Marie Pesce, RN-C,MSN

  • Family Nurse Practitioner
  • McDonough, GA
National Provider Identifier
1417028655
Registry record updated May 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN097976 NP Issued in GA
Practice address
50 Kelly Rd
McDonough, GA 30253-6097
Phone
(770) 957-1887
Fax
(770) 957-6864
NPI assigned
Nov 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2020

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 RN097976 NP GA Primary

Addresses

Primary practice location

50 Kelly Rd
McDonough, GA 30253-6097

Mailing address

50 Kelly Rd
McDonough, GA 30253-6097
Phone (770) 957-1887

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160519001267 GA Practitioner - Family Practice 8820387517 Reassigns benefits to 1 organization
I20200618002994 GA Practitioner - Nurse Practitioner 8820387517 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1996
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)

50 Kelly Rd
Suite 200
McDonough, GA 30253-6097
Phone (770) 914-0116

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
RN097976 NPGAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Aylo Health, LLC Current Accepting new patients
Aylo Health, LLC CurrentSince May 18, 2020 Accepting new patients
McDonough Primary Care Inc CurrentSince Apr 20, 2016 Accepting new patients
Aylo Health, LLC CurrentSince May 18, 2020 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

2330 Patrick Henry Pkwy
Ste 200
McDonough, GA 30253

50 Kelly Rd
McDonough, GA 30253
Phone (770) 957-1887

68 Hampton St
McDonough, GA 30253
Phone (770) 914-0342

50 Kelly Rd
Ste 200
McDonough, GA 30253
Phone (770) 957-1887

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

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CICCDA
  • Direct secure messaging: jodi.pesce@elfp.eclinicaldirectplus.com

Organizations & group practices 7

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": "1163116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590710400000",
    "number": "1417028655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 KELLY RD",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302536097",
            "telephone_number": "770-957-1887",
            "fax_number": "770-957-6864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 KELLY RD",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302536097",
            "telephone_number": "770-957-1887",
            "fax_number": "770-957-6864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PESCE",
        "first_name": "JODI",
        "middle_name": "MARIE",
        "credential": "RN-C,MSN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-10",
        "last_updated": "2020-05-29",
        "certification_date": "2020-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN097976 NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McDonough, GA

Sources for this page

Verify at the official NPI Registry.