Individual provider Active NPI

Jenessa Martin, PNP-PC

  • Pediatric Nurse Practitioner
  • Atlanta, GA
National Provider Identifier
1871213850
Registry record updated Nov 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
APRN-NP264795 Issued in GA
Practice address
5730 Glenridge Dr Ste 200
Atlanta, GA 30328-5579
Phone
(404) 252-5206
NPI assigned
Aug 31, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X APRN-NP264795 GA
Pediatric Nurse Practitioner 363LP0200X APRN-NP264795 GA Primary

Addresses

Primary practice location

5730 Glenridge Dr Ste 200
Atlanta, GA 30328-5579

Mailing address

1930 Brannan Rd
McDonough, GA 30253-4310

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
APRN-NP264795GAMDPediatric Nurse Practitioner

Interoperability endpoints

  • Direct secure messaging: jenessa.martin.p1@direct.gupa.nextgenshare.com

NPI Registry JSON

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

{
    "created_epoch": "1661904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763942400000",
    "number": "1871213850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1930 BRANNAN RD",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302534310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5730 GLENRIDGE DR STE 200",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303285579",
            "telephone_number": "404-252-5206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "JENESSA",
        "name_prefix": "Mrs.",
        "credential": "PNP-PC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-31",
        "last_updated": "2025-11-24",
        "certification_date": "2025-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "APRN-NP264795",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "GA",
            "license": "APRN-NP264795",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2025; 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.