Individual provider Active NPI

Jennifer Mote, M.D.

  • Pediatrics Physician
  • Augusta, GA
National Provider Identifier
1881655892
Registry record updated Apr 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
051795 Issued in GA
Practice address
1245 Augusta West Pkwy
Augusta, GA 30909-1807
Phone
(706) 868-0389
Fax
(706) 651-0729
NPI assigned
Mar 29, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Adolescent Medicine Physician 2080A0000X 051795 GA
Pediatrics Physician 208000000X 051795 GA Primary

Addresses

Primary practice location

1245 Augusta West Pkwy
Augusta, GA 30909-1807

Mailing address

1245 Augusta West Pkwy
Augusta, GA 30909-1807
Phone (706) 868-0389

Other identifiers 1

IdentifierTypeStateIssuer
000960374AMedicaidGA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address apa_admin@knology.net

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
051795GAMDPediatric Adolescent Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Augusta Pediatric Associates, P.C. Adolescent Medicine Past Accepting new patients

Organizations & group practices 1

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": "1143590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713225600000",
    "number": "1881655892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1245 AUGUSTA WEST PKWY",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309091807",
            "telephone_number": "706-868-0389",
            "fax_number": "706-651-0729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1245 AUGUSTA WEST PKWY",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309091807",
            "telephone_number": "706-868-0389",
            "fax_number": "706-651-0729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOTE",
        "first_name": "JENNIFER",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-29",
        "last_updated": "2024-04-16",
        "certification_date": "2024-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "GA",
            "license": "051795",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "051795",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000960374A",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "apa_admin@knology.net",
            "affiliation": "N",
            "address_1": "1245 Augusta West Pkwy",
            "city": "Augusta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "309091807",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Augusta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 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.