Jennifer Waite, AGACNP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

RN229350 Issued in GA

Practice address

743 Spring St NE
Gainesville, GA 30501-3715

Phone

(770) 534-2020

Fax

(770) 534-8025

NPI assigned

Oct 9, 2017

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

Electronic endpoints 1

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

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northside Cardiovascular Professional Services, LLCGroup PAC ID 9739189838, 143 clinicians

Georgia Heart Institute LLCGroup PAC ID 4183848062, 127 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northeast Georgia Medical Center, Inc Hospital, Gainesville, GA, CCN 110029
• Northside Hospital Gwinnett Hospital, Lawrenceville, GA, CCN 110087

Merit-based Incentive Payment System (MIPS)

Final score

88.46 of 100Reported as group

Quality

85.33

Promoting interoperability

100

Improvement activities

40

Cost

76.19

Merit-based Incentive Payment System (MIPS)

Final score

77.82 of 100Reported as group

Quality

67.82

Promoting interoperability

77

Improvement activities

40

Cost

77.43

Medicare enrollment (NPD)

Enrolled

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.

• Georgia Heart Institute LLC

  • Cardiovascular Disease Physician
  • Gainesville, GA
  • NPI 1477976520
  Medicare reassignment Care Compare group NPD
• Northside Cardiovascular Professional Services, LLC

  • Cardiovascular Disease Physician
  • Roswell, GA
  • NPI 1518979921
  Medicare reassignment Care Compare group NPD
• Northeast Georgia Heart Center

  • Cardiovascular Disease Physician
  • Gainesville, GA
  • NPI 1508812421
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Northeast Georgia Medical Center, Inc.

  • General Acute Care Hospital
  • Gainesville, GA
  • NPI 1427055821
  Care Compare affiliation
• Northside Hospital, Inc.

  • General Acute Care Hospital
  • Lawrenceville, GA
  • NPI 1952340994
  Care Compare affiliation

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

{
    "created_epoch": "1507507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607299200000",
    "number": "1740790476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 742616",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303742616",
            "telephone_number": "770-219-8420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "743 SPRING ST NE",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013715",
            "telephone_number": "770-534-2020",
            "fax_number": "770-534-8025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAITE",
        "first_name": "JENNIFER",
        "credential": "AGACNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-09",
        "last_updated": "2020-12-07",
        "certification_date": "2020-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "GA",
            "license": "RN229350",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GEORGIA BOARD OF NURSING",
            "identifier": "RN229350",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jwaite102655@nghs.gadirect.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "743 Spring St NE",
            "city": "Gainesville",
            "state": "GA",
            "country_code": "US",
            "postal_code": "305013715",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• David Michael Wade, PA
• Frank T. Waggoner Jr., DDS
• Amanda Nicole Wagner, PA
• Christy Wagner, MD
• Laurieann Wagner, RN
• Kevin Douglas Waits, MD
• Wal-Mart Stores East LP
• Wal-Mart Stores East LP
• Wal-Mart Stores East LP
• Wal-Mart Stores East, LP

• Gerontology Nurse Practitioner in Gainesville, GA
• Providers in Gainesville, GA by specialty
• Gerontology Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.