Individual provider Active NPI

Jennifer Armacost Gray, AGACNP

  • Nurse Practitioner
  • Lawrenceville, GA
National Provider Identifier
1508430893
Registry record updated Jul 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN248100 Issued in GA
Practice address
755 Walther Rd
Lawrenceville, GA 30046-8725
Phone
(770) 962-4895
Fax
(678) 377-3816
NPI assigned
May 19, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 248100 GA
Nurse Practitioner 363L00000X RN248100 GA Primary

Addresses

Primary practice location

755 Walther Rd
Lawrenceville, GA 30046-8725

Mailing address

755 Walther Rd
Lawrenceville, GA 30046-8725
Phone (770) 962-4895

Other names 1

  • Jennifer Armacost Brewington Former name

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
I20210823001124 GA Practitioner - Nurse Practitioner 0547665077 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Emory Clinic IncGroup PAC ID 8820901408, 3,507 clinicians

Practice addresses (Care Compare)

1365 Clifton Rd NE
Atlanta, GA 30322-1013
Phone (404) 778-7525

Hospital & facility affiliations

  • Emory University Hospital Hospital, Atlanta, GA, CCN 110010

Merit-based Incentive Payment System (MIPS)

Final score
76.66 of 100Reported as group
Quality
58.46
Promoting interoperability
83
Improvement activities
40
Cost
77.92

Merit-based Incentive Payment System (MIPS)

Final score
94.51 of 100Reported as apm
Quality
80.61
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
248100GAMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Emory Clinic Inc Cardiovascular Disease CurrentSince May 2, 2024 Accepting new patients

Locations

1365 Clifton Rd NE
Atlanta, GA 30322
Phone (404) 778-7525

2201 Henderson Mill Rd NE
Ste 160
Atlanta, GA 30345
Phone (404) 251-2193

Organizations & group practices 1

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 2

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": "1621382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625529600000",
    "number": "1508430893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "755 WALTHER RD",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300468725",
            "telephone_number": "770-962-4895",
            "fax_number": "678-377-3816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "755 WALTHER RD",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300468725",
            "telephone_number": "770-962-4895",
            "fax_number": "678-377-3816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY",
        "first_name": "JENNIFER",
        "middle_name": "ARMACOST",
        "credential": "AGACNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-19",
        "last_updated": "2021-07-06",
        "certification_date": "2021-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "GA",
            "license": "248100",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN248100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "BREWINGTON",
            "middle_name": "ARMACOST",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lawrenceville, GA

Sources for this page

Verify at the official NPI Registry.