Jennifer Michelle Bertram

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN269136 Issued in GA

Practice address

771 Roundtree Dr SW Ste a
Dawson, GA 39842-1683

Phone

(229) 270-1905

Fax

(229) 270-1915

NPI assigned

May 20, 2021

Last updated

Aug 23, 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

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

Medicare enrollment (NPD)

Enrolled

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.

• Albany Area Community SVC. Board

  • Public Health or Welfare Agency
  • Albany, GA
  • NPI 1063464212
  Medicare reassignment NPD

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

{
    "created_epoch": "1621468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692748800000",
    "number": "1891369120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "771 ROUNDTREE DR SW STE A",
            "city": "DAWSON",
            "state": "GA",
            "postal_code": "398421683",
            "telephone_number": "229-270-1905",
            "fax_number": "229-270-1915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "771 ROUNDTREE DR SW STE A",
            "city": "DAWSON",
            "state": "GA",
            "postal_code": "398421683",
            "telephone_number": "229-270-1905",
            "fax_number": "229-270-1915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERTRAM",
        "first_name": "JENNIFER",
        "middle_name": "MICHELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-20",
        "last_updated": "2023-08-23",
        "certification_date": "2023-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN269136",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Albany Area Primary Health Care, Inc. (Terrell County School-Based Health Center)
• Albany Area Primary Health Care, Inc. (Dawson Medical Center)
• Mindy Baldwin
• Whittnye Barksdale, NP-C
• BFJ Healthcare Agency
• BFJ Healthcare Agency
• Amika Shontika Brooks
• Shelia T Butler-Teal
• Careconnect Health, Inc. (CareConnect Convenient Care)

• Family Nurse Practitioner in Dawson, GA
• Providers in Dawson, 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 Aug 23, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.