Individual provider Active NPI

Justin Ross, AGACNP

  • Acute Care Nurse Practitioner
  • Gainesville, GA
National Provider Identifier
1538008792
Registry record updated May 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
RN294820 Issued in GA
Practice address
1315 Jesse Jewell Pkwy NE Ste 300
Gainesville, GA 30501-3875
Phone
(770) 219-6520
NPI assigned
Mar 25, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X RN294820 GA Primary
Infusion Therapy Registered Nurse 163WI0500X RN294820 GA

Addresses

Primary practice location

1315 Jesse Jewell Pkwy NE Ste 300
Gainesville, GA 30501-3875

Mailing address

PO Box 742616
Atlanta, GA 30374-2616
Phone (770) 219-8420

Other practice location 1

8644 Decoy Ln
Lula, GA 30554-6609
Phone (404) 281-8370 ext. 18370

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of South Alabama College of Medicine, 2026
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

PO Box
Atlanta, GA 30374

PO Box
Suite 742616
Atlanta, GA 30374-2616

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN294820GAMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Georgia Physicians Group Inc CurrentSince Jul 1, 2013 Accepting new patients

Locations

1315 Jesse Jewell Pkwy NE
Ste 300
Gainesville, GA 30501
Phone (770) 219-6520

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

1315 Jesse Jewell Pkwy NE
Ste 110
Gainesville, GA 30501
Phone (770) 219-0023

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.

NPI Registry JSON

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

{
    "created_epoch": "1774396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779753600000",
    "number": "1538008792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 742616",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303742616",
            "telephone_number": "770-219-8420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1315 JESSE JEWELL PKWY NE STE 300",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013875",
            "telephone_number": "770-219-6520"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8644 Decoy Ln",
            "address_purpose": "LOCATION",
            "city": "Lula",
            "state": "GA",
            "postal_code": "305546609",
            "country_code": "US",
            "telephone_number": "404-281-8370 x18370",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROSS",
        "first_name": "JUSTIN",
        "credential": "AGACNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-03-25",
        "last_updated": "2026-05-26",
        "certification_date": "2026-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "GA",
            "license": "RN294820",
            "primary": true
        },
        {
            "code": "163WI0500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Infusion Therapy",
            "state": "GA",
            "license": "RN294820",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, GA

Sources for this page

Verify at the official NPI Registry.