Individual provider Active NPI

Jennifer Brooke Rangel, NP

  • Nurse Practitioner
  • Watkinsville, GA
National Provider Identifier
1750001764
Registry record updated Jan 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN245513 Issued in GA
Practice address
1305 Jennings Mill Rd BLDG 300-110
Watkinsville, GA 30677-7238
Phone
(706) 613-5880
NPI assigned
Aug 30, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 5016872 NC
Nurse Practitioner 363L00000X RN245513 GA Primary
Registered Nurse 163W00000X 331788 NC

Addresses

Primary practice location

1305 Jennings Mill Rd BLDG 300-110
Watkinsville, GA 30677-7238

Mailing address

46 Memorial Dr
Pinehurst, NC 28374-8707
Phone (910) 715-1000

Other practice location 1

155 Memorial Dr
Pinehurst, NC 28374-8710
Phone (910) 715-1000

Other identifiers 1

IdentifierTypeStateIssuer
1750001764MedicaidNC

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
I20250219002448 GA Practitioner - Nurse Practitioner 5698142966 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Piedmont Athens Specialty Care LLCGroup PAC ID 8820349772, 116 clinicians

Practice addresses (Care Compare)

1010 Prince Ave
Suite 700
Athens, GA 30606-5812
Phone (706) 613-5880

1199 Prince Ave
Athens, GA 30606-2797
Phone (706) 475-7000

340 Exchange Blvd
Bethlehem, GA 30620-1759
Phone (678) 963-7171

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.84 of 100Reported as group
Quality
79.14
Promoting interoperability
92
Improvement activities
40
Cost
80.32

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hospital Physician Services - Southeast Professional Corporation Nurse Practitioner CurrentSince Nov 17, 2024 Accepting new patients
Piedmont Athens Specialty Care LLC CurrentSince Dec 1, 2024 Accepting new patients

Locations

1643 NW 136th Ave
Ste 100
Sunrise, FL 33323
Phone (865) 500-1325

340 Exchange Blvd
Bethlehem, GA 30620
Phone (678) 963-7171

2151 W Spring St
Monroe, GA 30655
Phone (770) 267-1792

501 Redmond Rd NW
Rome, GA 30165
Phone (706) 291-0291

1305 Jennings Mill Rd
Bldg 300110
Watkinsville, GA 30677
Phone (706) 613-5880

Organizations & group practices 2

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1661817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736812800000",
    "number": "1750001764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "46 MEMORIAL DR",
            "city": "PINEHURST",
            "state": "NC",
            "postal_code": "283748707",
            "telephone_number": "910-715-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1305 JENNINGS MILL RD BLDG 300-110",
            "city": "WATKINSVILLE",
            "state": "GA",
            "postal_code": "306777238",
            "telephone_number": "706-613-5880"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "155 Memorial Dr",
            "address_purpose": "LOCATION",
            "city": "Pinehurst",
            "state": "NC",
            "postal_code": "283748710",
            "country_code": "US",
            "telephone_number": "910-715-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RANGEL",
        "first_name": "JENNIFER",
        "middle_name": "BROOKE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-30",
        "last_updated": "2025-01-14",
        "certification_date": "2025-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5016872",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN245513",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NC",
            "license": "331788",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1750001764",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Watkinsville, GA

Sources for this page

Verify at the official NPI Registry.