Individual provider Active NPI

Jenny Edwards Tolley, FNP-C

  • Primary Care Nurse Practitioner
  • Danielsville, GA
National Provider Identifier
1780283200
Registry record updated Nov 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
RN256290 Issued in GA
Practice address
25 Nomora Dr
Danielsville, GA 30633-7058
Phone
(706) 795-9588
NPI assigned
Oct 26, 2020
Last updated
Nov 6, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 6, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN256290 GA
Primary Care Nurse Practitioner 363LP2300X RN256290 GA Primary

Addresses

Primary practice location

25 Nomora Dr
Danielsville, GA 30633-7058

Mailing address

125 Xavier Dr
Athens, GA 30606-3834
Phone (706) 654-7577

Other practice location 1

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

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
I20221230001845 GA Practitioner - Nurse Practitioner 0648640904 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Alabama School of Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Adams Primary Care PCGroup PAC ID 3173512795, 3 clinicians

Practice addresses (Care Compare)

25 Nomora Dr
Danielsville, GA 30633-7058
Phone (706) 795-9588

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.56 of 100Reported as group
Quality
87.45
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN256290GAMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Adams Primary Care, PC CurrentSince Sep 1, 2024 Accepting new patients
Georgia Emergency Medicine Specialists, PC CurrentSince Nov 1, 2022 Accepting new patients
Ingenios Health Co. PastSince Sep 1, 2024 Accepting new patients

Locations

1199 Prince Ave
Athens, GA 30606
Phone (706) 354-3520

25 Nomora Dr
Danielsville, GA 30633
Phone (215) 327-6344

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/FHBBAA

Organizations & group practices 3

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.

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": "1603670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730851200000",
    "number": "1780283200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 XAVIER DR",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306063834",
            "telephone_number": "706-654-7577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 NOMORA DR",
            "city": "DANIELSVILLE",
            "state": "GA",
            "postal_code": "306337058",
            "telephone_number": "706-795-9588"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1199 Prince Ave",
            "address_purpose": "LOCATION",
            "city": "Athens",
            "state": "GA",
            "postal_code": "306062797",
            "country_code": "US",
            "telephone_number": "706-475-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TOLLEY",
        "first_name": "JENNY",
        "middle_name": "EDWARDS",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-26",
        "last_updated": "2024-11-06",
        "certification_date": "2024-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN256290",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "GA",
            "license": "RN256290",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Danielsville, GA

Sources for this page

Verify at the official NPI Registry.