Individual provider Active NPI

Jessica Summers Donaldson, MD

  • Pediatrics Physician
  • Savannah, GA
National Provider Identifier
1487935979
Registry record updated Jan 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
077470 Issued in GA
Practice address
4700 Waters Ave
Savannah, GA 31404-6220
Phone
(912) 350-8193
Fax
(912) 350-3604
NPI assigned
Aug 29, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 077470 GA Primary

Addresses

Primary practice location

4700 Waters Ave
Savannah, GA 31404-6220

Mailing address

5002 Waters Ave
Savannah, GA 31404-6226
Phone (912) 350-8180

Other practice location 1

5002 Waters Ave
Savannah, GA 31404-6226
Phone (912) 350-8180

Other practice location 2

4700 Waters Ave
Savannah, GA 31404-6220
Phone (912) 350-8193

Other names 1

  • Jessica Anne Summers Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jdonaldson49530@epicsav.hcadirect.net

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
I20170801001326 GA Practitioner - Pediatric Medicine 8921379579 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
077470GAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
MPPG, Inc. Pediatrics CurrentSince Aug 1, 2017 Accepting new patients
Savannah Pediatric Care, LLC Pediatrics CurrentSince Feb 1, 2018 Accepting new patients

Locations

4700 Waters Ave
Savannah, GA 31404
Phone (912) 273-1100

5102 Paulsen St
Bldg 3
Savannah, GA 31405
Phone (912) 354-5814

5002 Waters Ave
Savannah, GA 31404
Phone (912) 350-2664

4731 Waters Ave
Savannah, GA 31404
Phone (912) 350-4905

Interoperability endpoints

  • Direct secure messaging: jdonaldson49530@epicsav.hcadirect.net

Organizations & group practices 2

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": "1314576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641254400000",
    "number": "1487935979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5002 WATERS AVE",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314046226",
            "telephone_number": "912-350-8180",
            "fax_number": "912-350-5697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 WATERS AVE",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314046220",
            "telephone_number": "912-350-8193",
            "fax_number": "912-350-3604"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5002 Waters Ave",
            "address_purpose": "LOCATION",
            "city": "Savannah",
            "state": "GA",
            "postal_code": "314046226",
            "country_code": "US",
            "telephone_number": "912-350-8180",
            "fax_number": "912-350-5697",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4700 Waters Ave",
            "address_purpose": "LOCATION",
            "city": "Savannah",
            "state": "GA",
            "postal_code": "314046220",
            "country_code": "US",
            "telephone_number": "912-350-8193",
            "fax_number": "912-350-3604",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DONALDSON",
        "first_name": "JESSICA",
        "middle_name": "SUMMERS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-29",
        "last_updated": "2022-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "077470",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jdonaldson49530@epicsav.hcadirect.net",
            "affiliation": "N",
            "address_1": "5002 Waters Ave",
            "city": "Savannah",
            "state": "GA",
            "country_code": "US",
            "postal_code": "314046226",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "SUMMERS",
            "middle_name": "ANNE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Savannah, GA

Sources for this page

Verify at the official NPI Registry.