Individual provider Active NPI

Jessica Knight, NP

  • Nurse Practitioner
  • Macon, GA
National Provider Identifier
1487000501
Registry record updated Jul 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN209049 Issued in GA
Practice address
840 Pine St
Ste 900
Macon, GA 31201-2100
Phone
(478) 633-8060
Fax
(478) 633-4080
NPI assigned
May 7, 2016
Last updated
Jul 16, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2016

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 RN209049 GA Primary

Addresses

Primary practice location

840 Pine St
Ste 900
Macon, GA 31201-2100

Mailing address

840 Pine St Ste 900
Macon, GA 31201-7500
Phone (478) 633-8060

Other identifiers 2

IdentifierTypeStateIssuer
202506I639OtherGAGA MEDICARE PTAN
003177341AMedicaidGA

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
I20160715001265 GA Practitioner - Nurse Practitioner 7719279439 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN209049GAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Gastroenterology Associates of Central Ga, LLC CurrentSince Feb 1, 2018 Accepting new patients
Central Georiga Fertility Institute Past Accepting new patients
Synergetic Healings LLC Past Accepting new patients

Locations

610 3rd St
Ste 100
Macon, GA 31201
Phone (478) 745-8205

610 3rd St
Ste 202
Macon, GA 31201
Phone (478) 216-7378

Interoperability endpoints

  • Direct secure messaging: jessica.knight@gaocg.eclinicaldirectplus.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1462579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468627200000",
    "number": "1487000501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "840 PINE ST STE 900",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312017500",
            "telephone_number": "478-633-8060",
            "fax_number": "478-633-4080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 PINE ST",
            "address_2": "STE 900",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312012100",
            "telephone_number": "478-633-8060",
            "fax_number": "478-633-4080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNIGHT",
        "first_name": "JESSICA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-07",
        "last_updated": "2016-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN209049",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GA MEDICARE PTAN",
            "identifier": "202506I639",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003177341A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Macon, GA

Sources for this page

Verify at the official NPI Registry.