Individual provider Active NPI

Jennifer Carter Wiegand, ACNP

  • Acute Care Nurse Practitioner
  • Clermont, GA
National Provider Identifier
1548444573
Registry record updated Jan 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
RN126531 Issued in GA
Practice address
5281 Cleveland Hwy
Clermont, GA 30527-2205
Phone
(770) 983-4611
Fax
(770) 983-9143
NPI assigned
Dec 27, 2007
Last updated
Jan 4, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2021

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 RN126531 GA Primary
Family Nurse Practitioner 363LF0000X RN126531 GA

Addresses

Primary practice location

5281 Cleveland Hwy
Clermont, GA 30527-2205

Mailing address

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

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jwiegand30036@nghs.gadirect.net Direct

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
I20080414000579 GA Practitioner - Nurse Practitioner 0143307215 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Emory University School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northside Urgent Care Holding LLCGroup PAC ID 4587984695, 77 clinicians

Practice addresses (Care Compare)

610 Peachtree Pkwy
Suite 100
Cumming, GA 30041-9762
Phone (678) 513-5260

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.83 of 100Reported as group
Quality
80.36
Promoting interoperability
100
Improvement activities
40
Cost
79.08

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Northside Primary Care Professional Services, LLC CurrentSince Aug 2, 2025 Accepting new patients
Northside Urgent Care Holding, LLC CurrentSince May 15, 2024 Accepting new patients
Northeast Georgia Physicians Group Inc CurrentSince Nov 1, 2012 Accepting new patients
Northside Primary Care Professional Services,LLC CurrentSince Aug 2, 2025 Accepting new patients
Wellstar Medical Group, LLC Past Accepting new patients

Locations

1110 W Peachtree St NW
Ste 200B
Atlanta, GA 30309
Phone (404) 575-2000

5281 Cleveland Hwy
Clermont, GA 30527
Phone (770) 983-1611

1505 Northside Blvd
Ste 4400
Cumming, GA 30041
Phone (678) 513-4275

610 Peachtree Pkwy
Ste 100
Cumming, GA 30041
Phone (678) 513-5260

81 Northside Dawson Dr
Ste 100A
Dawsonville, GA 30534
Phone (706) 216-6000

597 S Enota Dr NE
Gainesville, GA 30501
Phone (770) 219-8275

1000 Medical Center Blvd
Lawrenceville, GA 30046
Phone (678) 312-3356

1000 Johnson Ferry Rd
Sandy Springs, GA 30342
Phone (404) 851-8737

3350 Paddocks Pkwy
Suwanee, GA 30024
Phone (678) 474-9633

Interoperability endpoints

  • Direct secure messaging: jwiegand30036@nghs.gadirect.net

Organizations & group practices 5

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.

Hospital & facility affiliations 1

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": "1198713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609718400000",
    "number": "1548444573",
    "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": "5281 CLEVELAND HWY",
            "city": "CLERMONT",
            "state": "GA",
            "postal_code": "305272205",
            "telephone_number": "770-983-4611",
            "fax_number": "770-983-9143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIEGAND",
        "first_name": "JENNIFER",
        "middle_name": "CARTER",
        "name_prefix": "Mrs.",
        "credential": "ACNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-27",
        "last_updated": "2021-01-04",
        "certification_date": "2021-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "GA",
            "license": "RN126531",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN126531",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jwiegand30036@nghs.gadirect.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "5281 Cleveland Hwy",
            "city": "Clermont",
            "state": "GA",
            "country_code": "US",
            "postal_code": "305272205",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Clermont, GA

Sources for this page

Verify at the official NPI Registry.