Jennifer Undutch Rossignol, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

218226 Issued in GA

Practice address

865 N Highland Ave NE
Atlanta, GA 30306-4565

Phone

(404) 733-6089

NPI assigned

Mar 20, 2018

Last updated

Nov 9, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Jennifer Nicole Undutch Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Interoperability endpoints

• Direct secure messaging: jennifer.rossignol.1@10414.direct.athenahealth.com

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

{
    "created_epoch": "1521504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604880000000",
    "number": "1629572110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "865 N HIGHLAND AVE NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303064565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "865 N HIGHLAND AVE NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303064565",
            "telephone_number": "404-733-6089"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2625 N King St",
            "address_purpose": "LOCATION",
            "city": "Flagstaff",
            "state": "AZ",
            "postal_code": "860041884",
            "country_code": "US",
            "telephone_number": "928-679-7222",
            "fax_number": "928-679-7351",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2630 W El Camino Real",
            "address_purpose": "LOCATION",
            "city": "Mountain View",
            "state": "CA",
            "postal_code": "940401117",
            "country_code": "US",
            "telephone_number": "866-389-2727",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROSSIGNOL",
        "first_name": "JENNIFER",
        "middle_name": "UNDUTCH",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-20",
        "last_updated": "2020-11-09",
        "certification_date": "2020-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP10887",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95012490",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "218226",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "AP10887",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "UNDUTCH",
            "middle_name": "NICOLE",
            "credential": "FNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Rossi & Shirey, MD, PC
• Ana P Rossi, MD
• Matthew Rossi, PA-C
• Michael R. Rossi, PHD
• Toni Lynn Rossi, MD
• Sandy Davina Rossman, MSN, ANP-BC
• Maria Isabel Rosso, M.D.
• Bradley Rostad, MD
• Christina Allen Rostad, MD
• Roswell Nutrition LLC

• Family Nurse Practitioner in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.