Individual provider Active NPI

Jazzmine Jorden

  • Primary Care Nurse Practitioner
  • Duluth, GA
National Provider Identifier
1851039291
Registry record updated Oct 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
RN284472 Issued in GA
Practice address
3625 Savannah PL
Duluth, GA 30096-6376
Phone
(770) 707-4018
NPI assigned
May 25, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X RN284472 GA
Primary Care Nurse Practitioner 363LP2300X RN284472 GA Primary

Addresses

Primary practice location

3625 Savannah PL
Duluth, GA 30096-6376

Mailing address

PO Box 1612
Stockbridge, GA 30281-8612
Phone (770) 815-0663

Other practice location 1

1520 Clifton Rd NE
Atlanta, GA 30322-4201
Phone (404) 727-7980

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
RN284472GAMDPrimary Care Nurse Practitioner

Interoperability endpoints

  • Direct secure messaging: jazzmine.jorden.1@8042.direct.athenahealth.com

NPI Registry JSON

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

{
    "created_epoch": "1653436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728259200000",
    "number": "1851039291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1612",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302818612",
            "telephone_number": "770-815-0663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3625 SAVANNAH PL",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300966376",
            "telephone_number": "770-707-4018"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1520 Clifton Rd NE",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303224201",
            "country_code": "US",
            "telephone_number": "404-727-7980",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JORDEN",
        "first_name": "JAZZMINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-25",
        "last_updated": "2024-10-07",
        "certification_date": "2024-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "GA",
            "license": "RN284472",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "GA",
            "license": "RN284472",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.