Organization Active NPI

Frederick W. Jennart DO PC

  • Neurology Physician
  • Warner Robins, GA
National Provider Identifier
1487866703
Registry record updated Apr 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
Legal business name
FREDERICK W. JENNART DO PC
Practice address
212 Hospital Drive
Suite N
Warner Robins, GA 31088-4294
Phone
(478) 922-6698
Fax
(478) 922-4558
NPI assigned
May 7, 2007
Last updated
Apr 10, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2019

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

Authorized official

Name
Dr. Frederick W Jennart, DONPI 1821001025
Title
Physician
Phone
(478) 922-6698

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X NU Primary
Neurology with Special Qualifications in Child Neurology Physician 2084N0402X NU

Addresses

Primary practice location

212 Hospital Drive
Suite N
Warner Robins, GA 31088-4294

Mailing address

212 Hospital Drive
Suite N
Warner Robins, GA 31088-4294
Phone (478) 922-6698

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190306001610 GA Part B Supplier - Clinic/Group Practice 4688913890 Receives reassigned benefits from 1 practitioner
Practice locations: Warner Robins, GA

National Provider Directory

National Provider Directory

Locations

524 S Houston Lake Rd
Ste F200
Warner Robins, GA 31088
Phone (478) 922-6698

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1178496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1554854400000",
    "number": "1487866703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 HOSPITAL DRIVE",
            "address_2": "SUITE N",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "310884294",
            "telephone_number": "478-922-6698",
            "fax_number": "478-922-4558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 HOSPITAL DRIVE",
            "address_2": "SUITE N",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "310884294",
            "telephone_number": "478-922-6698",
            "fax_number": "478-922-4558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FREDERICK W. JENNART DO PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-07",
        "last_updated": "2019-04-10",
        "status": "A",
        "authorized_official_last_name": "JENNART",
        "authorized_official_first_name": "FREDERICK",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "478-922-6698",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warner Robins, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.