Kristal Lynne Jaster, PA-C
Individual provider Active NPI Physician Assistant · Port Wentworth, GA
NPI 1689768673 · NPPES record last updated Mar 17, 2018
Key facts
- NPI
- 1689768673
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 007452 (GA)
- Practice address
- 7306 Ga Highway 21 Ste 105
Port Wentworth, GA 31407-9275 - Phone
- (912) 966-2575
- Fax
- (912) 966-0906
- NPI assigned
- Oct 3, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 13
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Effingham Hospital Inc
Practice addresses (Care Compare)
459 Ga Hwy 119 S
Springfield, GA 31329-3021
Phone (912) 754-0480
459 Hwy 119 S
Springfield, GA 31329-3021
7306 Ga Hwy 21
Suite 105
Port Wentworth, GA 31407-9275
Phone (912) 826-1500
Hospital & facility affiliations
- Effingham Health System
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170118001928 | GA | Practitioner - Physician Assistant | 9739324088 | Reassigns benefits to 4 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6430 | NC | MD | General Practice Dentistry |
| 0010-04041 | NC | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Georgia Carenow Urgent Care LLC | Current |
Accepting new patients | |
| Effingham Hospital, Inc. | Current |
Accepting new patients | |
| Effingham Hospital, Inc. | Current |
Accepting new patients | |
| First Choice Community Health Centers | Past | Accepting new patients | |
| Effingham Hospital, Inc. | Past | Accepting new patients | |
| Effingham Hospital, Inc. | Past | Accepting new patients | |
| First Choice Community Health Centers | Past | Accepting new patients | |
| Effingham Hospital, Inc. | Past | Accepting new patients |
Locations
3 Hidden Creek Dr
Guyton, GA 31312
Phone (912) 772-8620
7306 State Highway 21
Ste 105
Port Wentworth, GA 31407
Phone (912) 826-1500
800 Towne Park Dr
Ste 100
Rincon, GA 31326
Phone (912) 826-0052
100 Goshen Rd
Rincon, GA 31326
Phone (912) 826-6000
14089 Abercorn St
Savannah, GA 31419
Phone (912) 349-4945
520 W 3rd St
Springfield, GA 31329
Phone (912) 826-7337
459 Highway 119 S
Springfield, GA 31329
Phone (912) 754-0200
1451 Highway 21 S
Ste H
Springfield, GA 31329
Phone (912) 754-1035
2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | 6430 | NC | |
| Physician Assistant | 363A00000X | 0010-04041 | NC | |
| Physician Assistant | 363A00000X | 007452 | GA | Yes |
Addresses
Primary practice location
7306 Ga Highway 21 Ste 105
Port Wentworth, GA 31407-9275
Mailing address
PO Box 818
Springfield, GA 31329-0818
Other practice location 1
1128 E. Derenne Ave
Savannah, GA 31406-2514
Phone (910) 583-4744
Other practice location 2
800 Towne Park Dr Ste 100
Rincon, GA 31326-5160
Phone (912) 826-0052
Other practice location 3
7306 Ga Highway 21 Ste 105
Port Wentworth, GA 31407-9275
Phone (912) 966-2575
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 007452 | Other | GA | PHYSICIAN ASSISTANT LICENSE |
Other names
- Mrs. Kristal Jaster
Other providers in Port Wentworth, GA
- Tia Tonette Haley-Crawford
- Healing Hands Family Healthcare
- Nichelle Hughes
- Independent Physical Therapy of Ga, LLC
- Intersections Behavioral Health LLC
- Regina Lashawne Jenkins
- Jessica Hulderman Doula
- Tanika Johnson
- Kera'S Nemt LLC
- Gwendolyn Renee Ladson
All providers in Port Wentworth, GA · Physician Assistant in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 17, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.