Individual provider Active NPI

Jessica Annelle Malone, NP-C

  • Nurse Practitioner
  • Macon, GA
National Provider Identifier
1659931277
Registry record updated Jun 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN255037 Issued in GA
Practice address
1062 Forsyth St
Macon, GA 31201-8637
Phone
(478) 741-1208
Fax
(478) 741-1557
NPI assigned
Jun 17, 2019
Last updated
Jun 17, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN255037 GA Primary

Addresses

Primary practice location

1062 Forsyth St
Macon, GA 31201-8637

Mailing address

462 Sweetwater LN
Gray, GA 31032-6376
Phone (478) 390-5029

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
I20190807004070 GA Practitioner - Nurse Practitioner 2961414263 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Georgia Heart Center, PCGroup PAC ID 0446248736, 27 clinicians

Practice addresses (Care Compare)

1062 Forsyth St
Suite 1B
Macon, GA 31201-8638
Phone (478) 741-1208

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Riverdale Radiology Center CurrentSince Dec 1, 2006 Accepting new patients
Central Georgia Heart Center, PC CurrentSince Sep 1, 2019 Accepting new patients
Central Georgia Heart Center, PC CurrentSince Sep 1, 2019 Accepting new patients

Locations

1062 Forsyth St
Ste 1B
Macon, GA 31201
Phone (912) 743-7068

750 N Cobb St
Ste 130
Milledgeville, GA 31061
Phone (478) 452-1024

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GGEADD
  • Direct secure messaging: jessica.malone@cghc.eclinicaldirectplus.com

Organizations & group practices 3

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1560729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560729600000",
    "number": "1659931277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "462 SWEETWATER LN",
            "city": "GRAY",
            "state": "GA",
            "postal_code": "310326376",
            "telephone_number": "478-390-5029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1062 FORSYTH ST",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312018637",
            "telephone_number": "478-741-1208",
            "fax_number": "478-741-1557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALONE",
        "first_name": "JESSICA",
        "middle_name": "ANNELLE",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-17",
        "last_updated": "2019-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN255037",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Macon, GA

Sources for this page

Verify at the official NPI Registry.