Joretta A Buckner, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN101831 Issued in GA

Practice address

200 Trilith Pkwy Ste 100
Fayetteville, GA 30214-4462

Phone

(404) 948-3019

NPI assigned

Jul 13, 2006

Last updated

Jul 19, 2022By 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 1

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

Emory University School of Medicine, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Piedmont Professional Services LLCGroup PAC ID 8921176231, 171 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Piedmont Professional Services, LLC

  • Nephrology Physician
  • Stockbridge, GA
  • NPI 1104088905
  Medicare reassignment Care Compare group NPD
• Minuteclinic LLC

  • Family Nurse Practitioner
  • Rockville, MD
  • NPI 1134191836

  GA

  Medicare reassignment NPD
• Piedmont Medical Care Corporation

  • Internal Medicine Physician
  • Atlanta, GA
  • NPI 1912956046
  NPD (past)

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658188800000",
    "number": "1851316665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "480 GLYNN ST N",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302141192",
            "telephone_number": "770-461-3431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 TRILITH PKWY STE 100",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302144462",
            "telephone_number": "404-948-3019"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "480 Glynn St N",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "GA",
            "postal_code": "302141192",
            "country_code": "US",
            "telephone_number": "770-461-3431",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUCKNER",
        "first_name": "JORETTA",
        "middle_name": "A",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-13",
        "last_updated": "2022-07-19",
        "certification_date": "2022-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN101831",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joy Brumbeloe, CNM
• Ian Bradley Brunet, D.C., BCAO
• Charlene Bryant, RBT
• K. Bryant
• Keisha Latonya Buchanan, LPC
• Benjamin Tyler Bullard
• Tanya Kennedy Bunting
• Courtney Burch, FNP
• Nykia Sherie Burke-Bray, M.D.
• John E Burney, M.D.

• Family Nurse Practitioner in Fayetteville, GA
• Providers in Fayetteville, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2022; 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.