Individual provider Active NPI

Jonita Green, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Atlanta, GA
National Provider Identifier
1730996273
Registry record updated Dec 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
243645 Issued in GA
Practice address
4300 Paces Ferry Rd SE
Atlanta, GA 30339-5703
Phone
(404) 759-7213
NPI assigned
Dec 17, 2024
Last updated
Dec 17, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 243645 GA Primary

Addresses

Primary practice location

4300 Paces Ferry Rd SE
Atlanta, GA 30339-5703

Mailing address

2721 Bench Cir
Ellenwood, GA 30294-5510
Phone (404) 759-7213

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
I20260527003308 GA Practitioner - Nurse Practitioner 6002386430 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2721 Bench Cir
Ellenwood, GA 30294-5510

720 Moreland Ave SE
Atlanta, GA 30316-3812

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
243645GAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Green Emerald Home Care Services Current Accepting new patients
Core Horizons Telepsychiatry Psychiatric/Mental Health Current Accepting new patients
Core Horizons Telepsychiatry Psychiatric/Mental Health Current Accepting new patients

Locations

4300 Paces Ferry Rd SE
Ste 500
Atlanta, GA 30339
Phone (404) 496-8960

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1734393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734393600000",
    "number": "1730996273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2721 BENCH CIR",
            "city": "ELLENWOOD",
            "state": "GA",
            "postal_code": "302945510",
            "telephone_number": "404-759-7213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4300 PACES FERRY RD SE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303395703",
            "telephone_number": "404-759-7213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "JONITA",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-12-17",
        "last_updated": "2024-12-17",
        "certification_date": "2024-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "GA",
            "license": "243645",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.