Jennifer H Puckett, MSN, ARNP, CPNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

628818 Issued in TX

Practice address

777 Franklin Rd SE
Marietta, GA 30067-7803

Phone

(770) 732-6007

Fax

(770) 732-8242

NPI assigned

May 19, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Jennifer H Lester Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Pediatric Nurse Practitioner, Master of Science - Nursing, Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Wellstar Medical Group, LLC

  • Multi-Specialty Clinic/Center
  • Marietta, GA
  • NPI 1275992240
  NPD
• Wellstar Medical Group, LLC

  • Pediatrics Physician
  • Kennesaw, GA
  • NPI 1457771925
  NPD
• Wellstar Medical Group, LLC

  • Family Medicine Physician
  • Kennesaw, GA
  • NPI 1558664003
  NPD
• Nuestros Ninos Our Kids Pediatrics Inc.

  • Pediatric Nurse Practitioner
  • Marietta, GA
  • NPI 1972756732

  Pediatrics

  NPD (past)

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391472000000",
    "number": "1710931548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3355 GEORGE BUSBEE PKWY NW",
            "address_2": "APT. 1001",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301446823",
            "telephone_number": "214-789-0423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 FRANKLIN RD SE",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300677803",
            "telephone_number": "770-732-6007",
            "fax_number": "770-732-8242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUCKETT",
        "first_name": "JENNIFER",
        "middle_name": "H",
        "name_prefix": "Ms.",
        "credential": "MSN, ARNP, CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-19",
        "last_updated": "2014-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "628818",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "152489401",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "LESTER",
            "middle_name": "H",
            "credential": "MSN, RN, CPNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Publix Super Markets Inc
• Publix Super Markets Inc
• Publix Super Markets Inc
• Publix Super Markets, Inc.
• Daniel Puchstein, LPTA
• Russell Prentice Puckett, MD
• Stephanie Soyka Puffer, PT, DPT
• Sandra B. Pulaski, APRN
• Sarah Shirley Pullani, OTR
• Pulmonary Wellstar

• Pediatric Nurse Practitioner in Marietta, GA
• Providers in Marietta, GA by specialty
• Pediatric Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.