Individual provider Active NPI

Jamie Rae McCracken, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Smyrna, GA
National Provider Identifier
1750991592
Registry record updated Aug 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
RN246456 Issued in GA
Practice address
2538 Gordon Cir SE
Smyrna, GA 30080-8123
Phone
(404) 775-1276
NPI assigned
Aug 6, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 6, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X RN246546 GA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X RN246456 GA Primary

Addresses

Primary practice location

2538 Gordon Cir SE
Smyrna, GA 30080-8123

Mailing address

2538 Gordon Cir SE
Smyrna, GA 30080-8123
Phone (404) 775-1276

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
I20210316002599 GA Practitioner - Nurse Practitioner 1759797764 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Personal Recovery Network LLCGroup PAC ID 5092611384, 612 clinicians

Practice addresses (Care Compare)

833 Campbell Hill St NW
Suite 350
Marietta, GA 30060-1163
Phone (470) 795-7695

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN246456GAMDPsychiatric/Mental Health Nurse Practitioner
RN246546GAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Personal Recovery Network LLC Single Specialty CurrentSince Mar 3, 2021 Accepting new patients

Locations

4255 Wade Green Rd NW
Ste 414
Kennesaw, GA 30144
Phone (678) 439-9952

833 Campbell Hill St NW
Ste 350
Marietta, GA 30060
Phone (404) 425-3339

250 Corporate Center Ct
Stockbridge, GA 30281
Phone (770) 954-8685

Interoperability endpoints

  • Direct secure messaging: georgiabehavioralhealthprofessionals.jamiemccracken@124220.advancedmd-direct.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1596672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596672000000",
    "number": "1750991592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2538 GORDON CIR SE",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300808123",
            "telephone_number": "404-775-1276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2538 GORDON CIR SE",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300808123",
            "telephone_number": "404-775-1276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCRACKEN",
        "first_name": "JAMIE",
        "middle_name": "RAE",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-06",
        "last_updated": "2020-08-06",
        "certification_date": "2020-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "GA",
            "license": "RN246546",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "GA",
            "license": "RN246456",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Smyrna, GA

Sources for this page

Verify at the official NPI Registry.