Individual provider Active NPI

Frederick W Jennart, DO

  • Neurology Physician
  • Warner Robins, GA
National Provider Identifier
1821001025
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
033365 Issued in GA
Practice address
212 Hospital Dr
Ste N
Warner Robins, GA 31088
Phone
(478) 922-6698
Fax
(478) 922-4558
NPI assigned
Aug 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 033365 GA Primary

Addresses

Primary practice location

212 Hospital Dr
Ste N
Warner Robins, GA 31088

Mailing address

212 Hospital Dr
Ste N
Warner Robins, GA 31088
Phone (478) 922-6698

Other identifiers 1

IdentifierTypeStateIssuer
00425653AMedicaidGA

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111109000137 GA Practitioner - Neurology 5092988915 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

212 Hospital Dr
Suite N
Warner Robins, GA 31088-4294

524 S Houston Lake Rd
Suite F200
Warner Robins, GA 31088-9049
Phone (478) 922-6698

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Frederick W. Jennart DO PC Neurology CurrentSince Aug 9, 1990 Accepting new patients

Locations

524 S Houston Lake Rd
Ste F200
Warner Robins, GA 31088
Phone (478) 922-6698

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/ECAFBA/Endpoint/ECAFBA
  • Direct secure messaging: frederick.jennart@fwjdp.eclinicaldirectplus.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": "1155600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1821001025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 HOSPITAL DR",
            "address_2": "STE N",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "31088",
            "telephone_number": "478-922-6698",
            "fax_number": "478-922-4558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 HOSPITAL DR",
            "address_2": "STE N",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "31088",
            "telephone_number": "478-922-6698",
            "fax_number": "478-922-4558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENNART",
        "first_name": "FREDERICK",
        "middle_name": "W",
        "name_prefix": "Mr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "GA",
            "license": "033365",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00425653A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Warner Robins, GA

Sources for this page

Verify at the official NPI Registry.