Jeremy Petty, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APRN-NP175210 Issued in GA

Practice address

4561 River Rd Ste a
Columbus, GA 31904-5828

Phone

(706) 478-5717

Fax

(706) 229-4883

NPI assigned

Aug 16, 2010

Sex

Male

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

Specialty

Nurse Practitioner

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Oak Street Health of Georgia PCGroup PAC ID 0345658647, 37 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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 and National Provider Directory roles.

• Oak Street Health of Georgia PC

  • Primary Care Clinic/Center
  • Stone Mountain, GA
  • NPI 1588258024

  Family

  Medicare reassignment Care Compare group NPD
• Aylo Health, LLC

  • Family Medicine Physician
  • Atlanta, GA
  • NPI 1013018811
  NPD (past)
• Aylo Health, LLC

  • Family Medicine Physician
  • Ellenwood, GA
  • NPI 1447290218
  NPD (past)
• Aylo Health, LLC

  • Family Medicine Physician
  • Locust Grove, GA
  • NPI 1710929914
  NPD (past)
• Aylo Health, LLC

  • Sleep Medicine (Family Medicine) Physician
  • Stockbridge, GA
  • NPI 1922831445
  NPD (past)

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

{
    "created_epoch": "1281916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762214400000",
    "number": "1942515812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 740015",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303740015",
            "telephone_number": "312-733-9730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4561 RIVER RD STE A",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319045828",
            "telephone_number": "706-478-5717",
            "fax_number": "706-229-4883"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2737 Warm Springs Rd",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "GA",
            "postal_code": "319046859",
            "country_code": "US",
            "telephone_number": "706-653-2255",
            "fax_number": "706-653-2329",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETTY",
        "first_name": "JEREMY",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-08-16",
        "last_updated": "2025-11-04",
        "certification_date": "2025-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "APRN-NP175210",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Summer L Peterson, BCBA
• Allison Shanley Petrenchak
• Kelly Pettis
• Tyleasha S Pettway
• Eric T. Petty, PT
• Deliana Peykova, MD
• Cynthia Pfeifler, RRT
• Shandis Denise Phaneuf, LPN
• Kiara Phelps, MD
• Sabin Phelps

• Family Nurse Practitioner in Columbus, GA
• Providers in Columbus, 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 Nov 4, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.