Individual provider Active NPI

Jennifer M Sartoris, DMSC, PA-C

  • Physician Assistant
  • Augusta, GA
National Provider Identifier
1659602100
Registry record updated Apr 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
14164631-1206 Issued in UT
Practice address
1 Freedom Way
Ms-22, Surgery
Augusta, GA 30904-6258
Phone
(706) 733-0188
Fax
(706) 823-1789
NPI assigned
Jan 22, 2010
Last updated
Apr 22, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5892 GA
Physician Assistant 363A00000X 14164631-1206 UT Primary
Surgical Physician Assistant 363AS0400X 5892 GA

Addresses

Primary practice location

1 Freedom Way
Ms-22, Surgery
Augusta, GA 30904-6258

Mailing address

1 Freedom Way
Ms-22, Surgery Service
Augusta, GA 30904-6258
Phone (706) 733-0188

Other practice location 1

Georgia Regents University
1120 15th Street, BA-3300
Augusta, GA 30912-0001
Phone (706) 721-4666

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5892GAMDPhysician Assistant
14164631-1206UTMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Au Medical Center, Inc Current Accepting new patients

Locations

1120 15th St
Augusta, GA 30912
Phone (706) 721-3873

1120 15th St
#3300
Augusta, GA 30912
Phone (706) 721-1633

1499 Walton Way
Ste 1400
Augusta, GA 30901
Phone (706) 721-4951

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1264118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745280000000",
    "number": "1659602100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 FREEDOM WAY",
            "address_2": "MS-22, SURGERY SERVICE",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309046258",
            "telephone_number": "706-733-0188",
            "fax_number": "706-823-1789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 FREEDOM WAY",
            "address_2": "MS-22, SURGERY",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309046258",
            "telephone_number": "706-733-0188",
            "fax_number": "706-823-1789"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Georgia Regents University",
            "address_2": "1120 15th Street, BA-3300",
            "address_purpose": "LOCATION",
            "city": "Augusta",
            "state": "GA",
            "postal_code": "309120001",
            "country_code": "US",
            "telephone_number": "706-721-4666",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SARTORIS",
        "first_name": "JENNIFER",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DMSC, PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-22",
        "last_updated": "2025-04-22",
        "certification_date": "2025-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "5892",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "14164631-1206",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "GA",
            "license": "5892",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2025; 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.