Jennifer Blue Avaliani, P.A.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

3794 Issued in GA

Practice address

2045 Peachtree Rd NE
Suite 525
Atlanta, GA 30309

Phone

(404) 351-7546

Fax

(678) 540-0100

NPI assigned

Jun 8, 2006

Last updated

Apr 30, 2020By the provider in NPPES

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

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• Direct secure messaging: javaliani@directaddress.net

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.

• Dermatology Consultants, P.C.

  • Dermatology Physician
  • Atlanta, GA
  • NPI 1851421531
  Medicare reassignment

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588204800000",
    "number": "1801837455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2045 PEACHTREE RD NE STE 200",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303091497",
            "telephone_number": "404-351-7546",
            "fax_number": "404-351-2993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2045 PEACHTREE RD NE",
            "address_2": "SUITE 525",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30309",
            "telephone_number": "404-351-7546",
            "fax_number": "678-540-0100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVALIANI",
        "first_name": "JENNIFER",
        "middle_name": "BLUE",
        "name_prefix": "Mrs.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-08",
        "last_updated": "2020-04-30",
        "certification_date": "2020-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "3794",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Av Dental Care, PC (Patient 1st Dental)
• Ava Family Services, LLC
• Ava Grace LLC
• Ava Therapy and Consulting LLC
• Vaidehi Avadhani, M.D.
• Evelynn Lucille Avant
• Travis Avant Jr.
• Avanta Care
• Jessica Avasthi, MS, RD, LD
• Ranjan K Avasthi, M.D.

• Physician Assistant in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.