Individual provider Active NPI

Jennifer W Stemberger, NP

  • Nurse Practitioner
  • Riverdale, GA
National Provider Identifier
1699790741
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
145780 Issued in GA
Practice address
6555 Professional PL
Suite C
Riverdale, GA 30274-4903
Phone
(770) 996-5959
Fax
(770) 991-1596
NPI assigned
Jul 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 145780 GA Primary

Addresses

Primary practice location

6555 Professional PL
Suite C
Riverdale, GA 30274-4903

Mailing address

6555 Professional PL
Suite C
Riverdale, GA 30274-4903
Phone (770) 996-5959

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
I20061218000256 GA Practitioner - Nurse Practitioner 3577562784 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern Gastroenterology Specialists, P.CGroup PAC ID 3577500214, 6 clinicians

Practice addresses (Care Compare)

1102 Hospital Dr
Stockbridge, GA 30281-6381
Phone (770) 692-0100

4865 Bill Gardner Pkwy
Locust Grove, GA 30248-3644
Phone (770) 692-0100

Merit-based Incentive Payment System (MIPS)

Final score
86.95 of 100Reported as group
Quality
90
Improvement activities
40
Cost
69.82

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
145780GAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Gastroenterology Specialists, P.C CurrentSince Oct 15, 2006 Accepting new patients

Locations

4865 Bill Gardner Pkwy
Locust Grove, GA 30248
Phone (770) 692-0100

6555 Professional Pl
Ste C
Riverdale, GA 30274
Phone (770) 692-0100

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GDFJAD
  • Direct secure messaging: jennifer.stemberger@sgscolon.eclinicaldirectplus.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1699790741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6555 PROFESSIONAL PL",
            "address_2": "SUITE C",
            "city": "RIVERDALE",
            "state": "GA",
            "postal_code": "302744903",
            "telephone_number": "770-996-5959",
            "fax_number": "770-991-1596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6555 PROFESSIONAL PL",
            "address_2": "SUITE C",
            "city": "RIVERDALE",
            "state": "GA",
            "postal_code": "302744903",
            "telephone_number": "770-996-5959",
            "fax_number": "770-991-1596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEMBERGER",
        "first_name": "JENNIFER",
        "middle_name": "W",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "145780",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverdale, GA

Sources for this page

Verify at the official NPI Registry.