Individual provider Active NPI

Jeninne Schwarz, PA-C

  • Physician Assistant
  • Carrollton, GA
National Provider Identifier
1881955938
Registry record updated Apr 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
705 Dixie St
Carrollton, GA 30117-3818
Phone
(770) 836-9666
NPI assigned
Jun 5, 2012
Last updated
Apr 11, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X GA Primary

Addresses

Primary practice location

705 Dixie St
Carrollton, GA 30117-3818

Mailing address

336 W Club Dr
Carrollton, GA 30117-4111

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20120827000431 GA Practitioner - Physician Assistant 5395992382 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellstreet of Georgia PCGroup PAC ID 7517126279, 425 clinicians

Practice addresses (Care Compare)

1524 Lafayette Pkwy
Lagrange, GA 30241-2566
Phone (706) 530-2151

1825 Hwy 34 E
Suite 1200
Newnan, GA 30265-6416
Phone (770) 502-2121

1825 Hwy 34 E 1200
Newnan, GA 30265-6416

2292 Peachtree Rd
Atlanta, GA 30309-1147
Phone (404) 382-9941

2505 Dallas Hwy SW
Marietta, GA 30064-2659
Phone (678) 956-6230

2976 Chapel Hill Rd
Douglasville, GA 30135-1733
Phone (678) 695-6960

35 Arbor Springs Ter
Newnan, GA 30265-4214
Phone (470) 323-5200

4475 W Village Pkwy
Ellenwood, GA 30294-2869
Phone (770) 507-7950

500 Nathan Dean Blvd
Suite 105
Dallas, GA 30157-4911
Phone (470) 624-6793

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
006491GAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Wellstreet of Georgia PC CurrentSince May 1, 2023 Accepting new patients

Locations

2292 Peachtree Rd NW
Atlanta, GA 30309
Phone (404) 382-9941

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1338854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681171200000",
    "number": "1881955938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "336 W CLUB DR",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301174111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 DIXIE ST",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301173818",
            "telephone_number": "770-836-9666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHWARZ",
        "first_name": "JENINNE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-05",
        "last_updated": "2023-04-11",
        "certification_date": "2023-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carrollton, GA

Sources for this page

Verify at the official NPI Registry.