Individual provider Active NPI

Jennifer Plunkett, MD

  • Surgery Physician
  • Atlanta, GA
National Provider Identifier
1669540043
Registry record updated Jan 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
058554 Issued in GA
Practice address
20 Glenlake Pkwy
Department of Surgery
Atlanta, GA 30328-3473
Phone
(770) 677-6227
NPI assigned
Dec 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 058554 GA Primary

Addresses

Primary practice location

20 Glenlake Pkwy
Department of Surgery
Atlanta, GA 30328-3473

Mailing address

1106 Oglethorpe Dr NE
Brookhaven, GA 30319-2783
Phone (404) 414-8211

Other names 1

  • Jennifer Dawn Tame Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq Health Information Exchange (HIE) The Permanente Medical Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091121000087 CA Practitioner - General Surgery 8022018506 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Chicago College of Medicine and Surgery, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Permanente Medical Group IncGroup PAC ID 8921910225, 10,928 clinicians

Practice addresses (Care Compare)

975 Sereno Dr
Vallejo, CA 94589-2441
Phone (707) 651-1000

99 Montecillo Rd
San Rafael, CA 94903-3308
Phone (415) 444-2000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Permanente Medical Group Inc Surgery Current Accepting new patients
Permanente Medical Group, Inc CurrentSince Jan 16, 2011 Accepting new patients
Permanente Medical Group Inc Surgery CurrentSince Jan 16, 2011 Accepting new patients

Locations

1150 Veterans Blvd
Redwood City, CA 94063
Phone (650) 299-2015

901 Nevin Ave
Richmond, CA 94801
Phone (510) 307-1500

2200 Ofarrell St
San Francisco, CA 94115
Phone (415) 202-2000

99 Montecillo Rd
San Rafael, CA 94903
Phone (415) 444-2047

710 Lawrence Expy
Santa Clara, CA 95051
Phone (408) 236-6400

7373 West Ln
Stockton, CA 95210
Phone (209) 476-2000

975 Sereno Dr
Vallejo, CA 94589
Phone (707) 651-1000

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641772800000",
    "number": "1669540043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1106 OGLETHORPE DR NE",
            "city": "BROOKHAVEN",
            "state": "GA",
            "postal_code": "303192783",
            "telephone_number": "404-414-8211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 GLENLAKE PKWY",
            "address_2": "DEPARTMENT OF SURGERY",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303283473",
            "telephone_number": "770-677-6227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PLUNKETT",
        "first_name": "JENNIFER",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-01",
        "last_updated": "2022-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "GA",
            "license": "058554",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "The Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "99 Montecillo Rd",
            "city": "San Rafael",
            "state": "CA",
            "country_code": "US",
            "postal_code": "949033308",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "TAME",
            "middle_name": "DAWN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.