Individual provider Active NPI

Jennifer Kelly Anderson, MD

  • Medical Oncology Physician
  • Gainesville, GA
National Provider Identifier
1457748451
Registry record updated Jul 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Oncology PhysicianTaxonomy code 207RX0202X
License
91283 Issued in GA
Practice address
725 Jesse Jewell Pkwy SE
Gainesville, GA 30501-3834
Phone
(770) 297-5700
Fax
(770) 219-9000
NPI assigned
Apr 17, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 29, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology (Internal Medicine) Physician 207RH0000X 91283 GA
Medical Oncology Physician 207RX0202X 91283 GA Primary

Addresses

Primary practice location

725 Jesse Jewell Pkwy SE
Gainesville, GA 30501-3834

Mailing address

PO Box 658
Gainesville, GA 30503-0658
Phone (770) 718-1877

Other practice location 1

1515 River Pl
Braselton, GA 30517-5602
Phone (770) 297-5700

Other practice location 2

1640 Falls Rd
Toccoa, GA 30577-2411
Phone (706) 886-5353

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220622003240 GA Practitioner - Hematology/Oncology 1153629795 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hematology/Oncology
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Longstreet Clinic, PCGroup PAC ID 2668465733, 140 clinicians
Northeast Georgia Community Physicians LLCGroup PAC ID 3274010582, 129 clinicians

Practice addresses (Care Compare)

725 Jesse Jewell Pkwy SE
Gainesville, GA 30501-3834
Phone (770) 533-6511

743 Spring St NE
Gainesville, GA 30501-3715
Phone (770) 219-9000

Hospital & facility affiliations

  • Northeast Georgia Medical Center, Inc Hospital, Gainesville, GA, CCN 110029
  • Northeast Georgia Medical Center Habersham Hospital, Demorest, GA, CCN 110041
  • Stephens County Hospital Hospital, Toccoa, GA, CCN 110032

Merit-based Incentive Payment System (MIPS)

Final score
89.1 of 100Reported as group
Quality
87.6
Promoting interoperability
100
Improvement activities
40
Cost
76.07

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
91283GAMDMedical Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Longstreet Clinic, PC Internal Medicine CurrentSince May 19, 2022 Accepting new patients
The Longstreet Clinic PC CurrentSince May 19, 2022 Accepting new patients
Northeast Georgia Community Physicians LLC Internal Medicine CurrentSince Feb 1, 2026 Accepting new patients

Locations

743 Spring St NE
Gainesville, GA 30501
Phone (770) 219-5915

725 Jesse Jewell Pkwy SE
Gainesville, GA 30501
Phone (770) 297-2200

1640 Falls Rd
Toccoa, GA 30577
Phone (706) 297-7023

Organizations & group practices 3

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 3

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": "1429228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659052800000",
    "number": "1457748451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 658",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305030658",
            "telephone_number": "770-718-1877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 JESSE JEWELL PKWY SE",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013834",
            "telephone_number": "770-297-5700",
            "fax_number": "770-219-9000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1515 River Pl",
            "address_purpose": "LOCATION",
            "city": "Braselton",
            "state": "GA",
            "postal_code": "305175602",
            "country_code": "US",
            "telephone_number": "770-297-5700",
            "fax_number": "770-219-7219",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1640 Falls Rd",
            "address_purpose": "LOCATION",
            "city": "Toccoa",
            "state": "GA",
            "postal_code": "305772411",
            "country_code": "US",
            "telephone_number": "706-886-5353",
            "fax_number": "770-297-7213",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "JENNIFER",
        "middle_name": "KELLY",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-04-17",
        "last_updated": "2022-07-29",
        "certification_date": "2022-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology",
            "state": "GA",
            "license": "91283",
            "primary": false
        },
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "GA",
            "license": "91283",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, GA

Sources for this page

Verify at the official NPI Registry.