Individual provider Active NPI

Jennifer Covode, RN, NP-C

  • Family Nurse Practitioner
  • Lawrenceville, GA
National Provider Identifier
1629423637
Registry record updated Mar 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN193407 Issued in GA
Practice address
1180 McKendree Church Rd
Suite Number 202
Lawrenceville, GA 30043-5207
Phone
(770) 817-4445
NPI assigned
Apr 27, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN193407 GA Primary

Addresses

Primary practice location

1180 McKendree Church Rd
Suite Number 202
Lawrenceville, GA 30043-5207

Mailing address

1180 McKendree Church Rd
Suite Number 202
Lawrenceville, GA 30043-5207
Phone (770) 817-4445

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
I20160906000274 GA Practitioner - Nurse Practitioner 7113213950 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northside Urgent Care Holding LLC 77 clinicians

Practice addresses (Care Compare)

81 Northside Dawson Dr
Suite 100a
Dawsonville, GA 30534-7166
Phone (706) 216-6000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN193407GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Northside Urgent Care Holding, LLC CurrentSince Aug 18, 2020 Accepting new patients
BHBD LLC CurrentSince Feb 21, 2018 Accepting new patients

Locations

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

460 Brannon Rd
Ste 101
Cumming, GA 30041
Phone (770) 573-2777

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

Organizations & group practices 2

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": "1461715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488758400000",
    "number": "1629423637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1180 MCKENDREE CHURCH RD",
            "address_2": "SUITE NUMBER 202",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300435207",
            "telephone_number": "770-817-4445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1180 MCKENDREE CHURCH RD",
            "address_2": "SUITE NUMBER 202",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300435207",
            "telephone_number": "770-817-4445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COVODE",
        "first_name": "JENNIFER",
        "credential": "RN, NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-27",
        "last_updated": "2017-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN193407",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceville, GA

Sources for this page

Verify at the official NPI Registry.