Anjelica Jefferson, CPNP-AC

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

APRN-NP230248 Issued in GA

Practice address

743 Spring St NE
Gainesville, GA 30501-3715

Phone

(770) 535-3611

Fax

(770) 535-7092

NPI assigned

Oct 28, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Pediatric Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Northeast Georgia Community Physicians LLC

  dba Longstreet of NGHS

  • Internal Medicine Physician
  • Gainesville, GA
  • NPI 1881583730
  Medicare reassignment NPD
• The Longstreet Clinic, PC

  • Internal Medicine Physician
  • Gainesville, GA
  • NPI 1326019977
  Medicare reassignment NPD
• The Longstreet Clinic PC

  • Prosthetic/Orthotic Supplier
  • Gainesville, GA
  • NPI 1053422428
  NPD

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

{
    "created_epoch": "1635379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761782400000",
    "number": "1568126118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2015 UPPERGATE DRIVE NEONATOLOGY DEPT",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303220001",
            "telephone_number": "404-727-3360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "743 SPRING ST NE",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013715",
            "telephone_number": "770-535-3611",
            "fax_number": "770-535-7092"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "550 Peachtree St NE",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303082212",
            "country_code": "US",
            "telephone_number": "404-686-4411",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1400 River Place",
            "address_purpose": "LOCATION",
            "city": "Braselton",
            "state": "GA",
            "postal_code": "305175600",
            "country_code": "US",
            "telephone_number": "770-535-3611",
            "fax_number": "770-535-7092",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JEFFERSON",
        "first_name": "ANJELICA",
        "credential": "CPNP-AC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-28",
        "last_updated": "2025-10-30",
        "certification_date": "2025-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": null,
            "license": "RN230248",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "GA",
            "license": "RN230248",
            "primary": false
        },
        {
            "code": "363LP0222X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics, Critical Care",
            "state": "GA",
            "license": "RN230248",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "GA",
            "license": "APRN-NP230248",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID",
            "identifier": "003262836",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eileen Javellana, MD
• Jacob Jay, MD
• Sharani Umayangani Jayaratne, MD
• Vanita Jayswal, MD
• Derianne Jeff-Eke, MD, MPH
• Nikolas Jen, DO
• Walter Thomas Jenkins, MD
• Laura S Jernigan, FNP
• Maurice Vernon Jeter Jr., MD
• Jennifer Leigh Jewett, OTR/L

• Acute Care Nurse Practitioner in Gainesville, GA
• Providers in Gainesville, GA by specialty
• Acute Care Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.