Jennifer Ellen Susoreny-Velgos, D.O.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

99331 Issued in GA

Practice address

1600 Vernon Rd Ste a
Lagrange, GA 30240-4143

Phone

(706) 880-7321

NPI assigned

Apr 30, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AR, GA2 enrollments

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 2

Specialty

General Surgery

Education

Lincoln Mem Univ, Debusk Col of Osteopathic Med, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Wellstar Medical Group LLCGroup PAC ID 6709065402, 3,059 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Wellstar West Georgia Medical Center Hospital, Lagrange, GA, CCN 110016

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Wellstar Medical Group, LLC

  • Family Medicine Physician
  • Kennesaw, GA
  • NPI 1558664003
  Medicare reassignment Care Compare group NPD
• St Mary'S Physician Services LLC

  • General Practice Physician
  • Russellville, AR
  • NPI 1124084991
  Medicare reassignment NPD
• Wellstar Medical Group, LLC

  • Multi-Specialty Clinic/Center
  • Marietta, GA
  • NPI 1275992240
  NPD
• St Marys Physician Services, LLC

  • Durable Medical Equipment & Medical Supplies
  • Russellville, AR
  • NPI 1063626117
  NPD
• St Marys Physician Services, LLC

  • Interventional Cardiology Physician
  • Russellville, AR
  • NPI 1720356207
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• West Georgia Medical Center, Inc.

  • General Acute Care Hospital
  • Lagrange, GA
  • NPI 1821221144
  Care Compare affiliation

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

{
    "created_epoch": "1335744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737504000000",
    "number": "1821356601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 VERNON RD STE A",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302404143",
            "telephone_number": "706-880-7321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 VERNON RD STE A",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302404143",
            "telephone_number": "706-880-7321"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 W Kingshighway",
            "address_2": "Suite 13",
            "address_purpose": "LOCATION",
            "city": "Paragould",
            "state": "AR",
            "postal_code": "72450",
            "country_code": "US",
            "telephone_number": "870-239-8107",
            "fax_number": "870-239-8115",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2202 State Ave Ste 108B",
            "address_purpose": "LOCATION",
            "city": "Panama City",
            "state": "FL",
            "postal_code": "324054539",
            "country_code": "US",
            "telephone_number": "850-252-7512",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUSORENY-VELGOS",
        "first_name": "JENNIFER",
        "middle_name": "ELLEN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-30",
        "last_updated": "2025-01-22",
        "certification_date": "2025-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "AR",
            "license": "E-10631",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "FL",
            "license": "OS-18050",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "GA",
            "license": "99331",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "221624003",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tamarah Strickland
• Amber Leeann Strub, DNP, PMHNP, BSN-RN
• Hannah Stuart
• Sue H. Turner
• Craig Sun, DPM
• Suzanne W Schuessler
• Clifford Daniel Thomas Swann
• Emmy R Swords, NP
• Maria Rebecca A Talley, PT
• Jennifer Cline Taunton, MSN, FNP-C

• Surgery Physician in Lagrange, GA
• Providers in Lagrange, GA by specialty
• Surgery Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2025; 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.