Individual provider Active NPI

Jessica Taylor, FNP-C

  • Family Nurse Practitioner
  • Valdosta, GA
National Provider Identifier
1831607670
Registry record updated Jan 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN245136 Issued in GA
Practice address
2412 N Oak St
Valdosta, GA 31602-2567
Phone
(229) 244-1400
Fax
(229) 244-5512
NPI assigned
Jan 15, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN245136 GA Primary

Addresses

Primary practice location

2412 N Oak St
Valdosta, GA 31602-2567

Mailing address

2412 N Oak St
Valdosta, GA 31602-2567
Phone (229) 244-1400

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
I20180719001262 GA Practitioner - Nurse Practitioner 1052668274 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Pruitthealth Physicians Services, LLC Family CurrentSince May 29, 2022 Accepting new patients
Valdosta Family Medicine Associates, P.C. Family CurrentSince Jan 12, 2018 Accepting new patients

Locations

1626 Jeurgens Ct
Norcross, GA 30093
Phone (770) 806-6875

2418 N Oak St
Valdosta, GA 31602
Phone (229) 289-1517

2412 N Oak St
Valdosta, GA 31602
Phone (229) 244-1400

Interoperability endpoints

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

Organizations & group practices 2

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": "1515974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1515974400000",
    "number": "1831607670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2412 N OAK ST",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316022567",
            "telephone_number": "229-244-1400",
            "fax_number": "229-244-5512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2412 N OAK ST",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316022567",
            "telephone_number": "229-244-1400",
            "fax_number": "229-244-5512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "JESSICA",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-15",
        "last_updated": "2018-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN245136",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valdosta, GA

Sources for this page

Verify at the official NPI Registry.