Judy Lynn Fajardo, AGCANP-BC

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

RN239574 Issued in GA

Practice address

902 N 7TH St
Cordele, GA 31015-3234

Phone

(229) 276-3100

NPI assigned

Sep 24, 2019

Last updated

Apr 13, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

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

Specialty

Nurse Practitioner

Education

University of South Alabama College of Medicine, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kidney Clinic Cordele LLCGroup PAC ID 9537568738, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

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

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.

• Kidney Clinic Cordele LLC

  • Nephrology Physician
  • Cordele, GA
  • NPI 1336726215
  Medicare reassignment Care Compare group NPD
• Andre D. Feria MD PC

  • Nephrology Physician
  • Lagrange, GA
  • NPI 1386780104
  Medicare reassignment NPD
• Crisp Regional Hospital Inc

  dba Crisp Regional Hospital

  • General Acute Care Hospital
  • Cordele, GA
  • NPI 1700851649
  Medicare reassignment NPD
• Crisp Regional Hospital, Inc

  dba Crisp Regional LTC Pharmacy

  • Long Term Care Pharmacy
  • Cordele, GA
  • NPI 1679836142
  NPD

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

{
    "created_epoch": "1569283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681344000000",
    "number": "1811548597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "902 N 7TH ST",
            "city": "CORDELE",
            "state": "GA",
            "postal_code": "310153234",
            "telephone_number": "229-276-3100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "902 N 7TH ST",
            "city": "CORDELE",
            "state": "GA",
            "postal_code": "310153234",
            "telephone_number": "229-276-3100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAJARDO",
        "first_name": "JUDY",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "AGCANP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-09-24",
        "last_updated": "2023-04-13",
        "certification_date": "2023-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "GA",
            "license": "RN239574",
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "GA",
            "license": "RN239574",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "GA",
            "license": "RN239574",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eagles at Home LLC
• Mohamed H Elgendy, MD
• Shelby Dozier Eubanks, NP-C
• Sherry Evans, ATR
• Lisa Patterson Faircloth, FNP-C
• Tiffany Merritt Fallin, NP
• Lauren Goforth Faulk, APRN, FNP-C
• Mary Gail Ferra, NPC
• Kenya Lavette Fields
• Timothy David Fitzgerald

• Acute Care Nurse Practitioner in Cordele, GA
• Providers in Cordele, GA by specialty
• Acute Care Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.