Individual provider Active NPI

Jennifer W Smith, PA-C

  • Physician Assistant
  • Lawrenceville, GA
National Provider Identifier
1609018068
Registry record updated Sep 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
007248 Issued in GA
Practice address
771 Old Norcross Rd
Suites 155 and 390
Lawrenceville, GA 30046-4386
Phone
(770) 682-6000
Fax
(770) 513-1103
NPI assigned
Apr 1, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 007248 GA Primary

Addresses

Primary practice location

771 Old Norcross Rd
Suites 155 and 390
Lawrenceville, GA 30046-4386

Mailing address

900 Circle 75 Pkwy SE
Suite 1700
Atlanta, GA 30339-3035
Phone (770) 953-6929

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
I20140915001815 GA Practitioner - Physician Assistant 9133277403 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Medical University of South Carolina College of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Peachtree Orthopaedic Clinic PAGroup PAC ID 4587552963, 138 clinicians

Practice addresses (Care Compare)

11800 Amberpark Dr
BLDG 1
Alpharetta, GA 30009-2274
Phone (404) 355-0743

2001 Peachtree Rd NE
Suite 705
Atlanta, GA 30309-1476
Phone (404) 355-0743

3200 Downwood Cir NW
Suite 700
Atlanta, GA 30327-5308
Phone (404) 355-0743

5505 Peachtree Dunwoody Rd
Suite 600
Atlanta, GA 30342-1717
Phone (404) 425-1577

Merit-based Incentive Payment System (MIPS)

Final score
94.9 of 100Reported as group
Promoting interoperability
94
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
007248GAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Peachtree Orthopaedic Clinic CurrentSince Sep 25, 2023 Accepting new patients
Peachtree Orthopaedic Clinic, P.a. CurrentSince Sep 25, 2023 Accepting new patients
Orthoatlanta, LLC Past Accepting new patients
Peachtree Orthopaedic Clinic PA Past Accepting new patients

Locations

2001 Peachtree Rd NE
Ste 705
Atlanta, GA 30309

Interoperability endpoints

  • Direct secure messaging: jennifer.smith.1@8474.direct.athenahealth.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1238544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441065600000",
    "number": "1609018068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 CIRCLE 75 PKWY SE",
            "address_2": "SUITE 1700",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303393035",
            "telephone_number": "770-953-6929",
            "fax_number": "770-953-6972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "771 OLD NORCROSS RD",
            "address_2": "SUITES 155 AND 390",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300464386",
            "telephone_number": "770-682-6000",
            "fax_number": "770-513-1103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JENNIFER",
        "middle_name": "W",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-01",
        "last_updated": "2015-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "007248",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceville, GA

Sources for this page

Verify at the official NPI Registry.