Individual provider Active NPI

Sarah Ann Jett, NP-C

  • Nurse Practitioner
  • Newnan, GA
National Provider Identifier
1790420123
Registry record updated Jul 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN270077 Issued in GA
Practice address
2045 Highway 34 East
Newnan, GA 30265-1325
Phone
(770) 502-0202
Fax
(770) 502-8822
NPI assigned
Apr 30, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN270077 GA Primary

Addresses

Primary practice location

2045 Highway 34 East
Newnan, GA 30265-1325

Mailing address

835 Cogburn Avenue
Suite 250
Marietta, GA 30060-1010
Phone (770) 422-8815

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
I20230728000031 GA Practitioner - Nurse Practitioner 3375904014 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aqua Dermatology of Georgia PCGroup PAC ID 6800885757, 56 clinicians

Practice addresses (Care Compare)

2045 Hwy 34 E
Newnan, GA 30265
Phone (770) 502-0202

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN270077GAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Aqua Dermatology of Georgia PC CurrentSince Jul 24, 2023 Accepting new patients
Dermatopathology Lab of Skin Cancer Specialists, P.C. CurrentSince Jul 24, 2023 Accepting new patients
Hospital Authority of the City of Bainbridge and Decatur County Past Accepting new patients

Locations

10 Cloverleaf Dr
Cartersville, GA 30120
Phone (770) 386-1261

1150 Brookstone Centre Pkwy
Columbus, GA 31904
Phone (706) 257-4189

850 Charles Hardy Pkwy
Dallas, GA 30157
Phone (770) 336-8888

835 Cogburn Ave NW
Ste 100
Marietta, GA 30060
Phone (770) 422-5557

835 Cogburn Ave NW
Ste 250
Marietta, GA 30060
Phone (770) 422-8815

2045 Highway 34 E
Newnan, GA 30265
Phone (770) 502-0202

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1651276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689724800000",
    "number": "1790420123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "835 COGBURN AVENUE",
            "address_2": "SUITE 250",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300601010",
            "telephone_number": "770-422-8815",
            "fax_number": "770-422-8816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2045 HIGHWAY 34 EAST",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302651325",
            "telephone_number": "770-502-0202",
            "fax_number": "770-502-8822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JETT",
        "first_name": "SARAH",
        "middle_name": "ANN",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-30",
        "last_updated": "2023-07-19",
        "certification_date": "2023-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN270077",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newnan, GA

Sources for this page

Verify at the official NPI Registry.