Jessica Podlaski

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

RN290281 Issued in GA

Practice address

595 Hurricane Shoals Rd NW
Suite 300
Lawrenceville, GA 30046

Phone

(770) 995-0823

Fax

(770) 995-7018

NPI assigned

Sep 16, 2022

Last updated

May 26, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/14859/brand/1/csg/1/fhir/r4

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.

• Gwinnett Pediatrics & Adolescent Medicine

  • Pediatrics Physician
  • Lawrenceville, GA
  • NPI 1003940909
  NPD (past)

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

{
    "created_epoch": "1663286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685059200000",
    "number": "1881316750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "595 HURRICANE SHOALS RD NW",
            "address_2": "SUITE 300",
            "city": "LAWERENCEVILLE",
            "state": "GA",
            "postal_code": "30046",
            "telephone_number": "770-995-0823",
            "fax_number": "770-995-7018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "595 HURRICANE SHOALS RD NW",
            "address_2": "SUITE 300",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "30046",
            "telephone_number": "770-995-0823",
            "fax_number": "770-995-7018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PODLASKI",
        "first_name": "JESSICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-16",
        "last_updated": "2023-05-26",
        "certification_date": "2023-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "GA",
            "license": "RN290281",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kasey Cathryn Payne Pitts, CNM
• Plastic Surgery of Gwinnett PC
• Archna Poddar, M.D.
• Satish B Poddar, M.D.
• Shashi Poddar, MD
• Joseph F Pohl, M.D.
• Lauren Pohl, RDN
• Donald E Poland, M.D.
• Ervin Polite
• Latoya Nichole Polk, LPC

• Pediatric Nurse Practitioner in Lawrenceville, GA
• Providers in Lawrenceville, GA by specialty
• Pediatric Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2023; 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.