Active NPI
Jessi M Prahl, ATC/L, OTC
- Surgical Technologist
- Atlanta, GA
National Provider Identifier
1710911631
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Technologist
- License
- 07-0825
- Practice address
- 1791 Rockland Dr SE
Atlanta, GA 30316-2239 - Phone
- (404) 406-9446
- NPI assigned
- Jul 10, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Other Specialist/Technologist | 246Z00000X | AT001300 | GA | |
| Surgical Technologist | 246ZS0410X | 07-0825 | GA | Primary |
Addresses
Primary practice location
1791 Rockland Dr SE
Atlanta, GA 30316-2239
Mailing address
1791 Rockland Dr SE
Atlanta, GA 30316-2239
Phone (404) 406-9446
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AT001300 | GA | MD | Other Specialist/Technologist |
| 07-0825 | GA | MD | Surgical Technologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152489600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1263772800000",
"number": "1710911631",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1791 ROCKLAND DR SE",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303162239",
"telephone_number": "404-406-9446"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1791 ROCKLAND DR SE",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303162239",
"telephone_number": "404-406-9446"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRAHL",
"first_name": "JESSI",
"middle_name": "M",
"name_prefix": "Ms.",
"credential": "ATC/L, OTC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-07-10",
"last_updated": "2010-01-18",
"status": "A"
},
"taxonomies": [
{
"code": "246Z00000X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Other",
"state": "GA",
"license": "AT001300",
"primary": false
},
{
"code": "246ZS0410X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Other, Surgical Technologist",
"state": "GA",
"license": "07-0825",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Atlanta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.