Individual provider Active NPI

Jennifer Evans

  • Family Medicine Physician
  • Macon, GA
National Provider Identifier
1942520093
Registry record updated May 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4152 Issued in GA
Practice address
770 Walnut St
Macon, GA 31201-7307
Phone
(478) 787-4266
Fax
(478) 787-4199
NPI assigned
Jun 10, 2010
Last updated
May 28, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4152 GA Primary

Addresses

Primary practice location

770 Walnut St
Macon, GA 31201-7307

Mailing address

PO Box 4363
Macon, GA 31208-4363
Phone (478) 787-4266

Other identifiers 1

IdentifierTypeStateIssuer
003134564AMedicaidGA

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130904000806 GA Practitioner - Family Practice 9830346618 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Meharry Medical College School of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Peachtree Immediate Care FP, LLCGroup PAC ID 3274559323, 328 clinicians
Wellstreet of Georgia PCGroup PAC ID 7517126279, 425 clinicians

Practice addresses (Care Compare)

1275 Hwy 54 W
Suite 201
Fayetteville, GA 30214-4538
Phone (770) 461-3776

1280 Dogwood Dr SE
Conyers, GA 30013-5046
Phone (404) 994-4662

2140 Riverside Dr
Suite C
Macon, GA 31204-1791

3400 Riverside Dr
Macon, GA 31210-2513
Phone (478) 474-5600

3780 Eisenhower Pkwy
Macon, GA 31206-0800
Phone (487) 633-5500

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4152GAMDFamily Medicine Physician
004152GAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
The Medical Center of Central Georgia Inc CurrentSince Feb 1, 2024 Accepting new patients
Rejuvenant Family Health Care Family Medicine CurrentSince Apr 1, 2024 Accepting new patients
Health Services of Central Georgia, Inc Family Medicine CurrentSince Feb 1, 2024 Accepting new patients
Wellstreet of Georgia PC CurrentSince Nov 3, 2023 Accepting new patients
Peachtree Immediate Care FP, LLC Family Medicine CurrentSince Mar 1, 2022 Accepting new patients
The Medical Center of Central Georgia Inc. Current Accepting new patients
Peachtree Immediate Care UC, LLC Past Accepting new patients

Locations

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

1111 Glynco Pkwy
Ste 10
Brunswick, GA 31525
Phone (912) 264-9111

2768 Watson Blvd
#100
Centerville, GA 31028
Phone (478) 302-0001

1280 Dogwood Dr SE
Conyers, GA 30013
Phone (404) 994-4662

1275 Highway 54 W
Ste 201
Fayetteville, GA 30214
Phone (770) 461-3776

590 Lanier Ave W
Fayetteville, GA 30214

898 Battlefield Pkwy
Fort Oglethorpe, GA 30742
Phone (706) 406-1860

3827 Jimmy Lee Smith Pkwy
Hiram, GA 30141
Phone (770) 222-8900

111 Colonial Way
Jesup, GA 31545
Phone (912) 427-8177

1481 Highway 40 E
Kingsland, GA 31548
Phone (912) 576-2565

2140 Riverside Dr
Ste C
Macon, GA 31204
Phone (478) 254-2770

3400 Riverside Dr
Macon, GA 31210
Phone (478) 474-5600

777 Hemlock St
Macon, GA 31201
Phone (478) 474-5600

1120 Morningside Dr
Perry, GA 31069
Phone (478) 218-1706

275 Perry Pkwy
Perry, GA 31069
Phone (478) 218-7582

275 Perry Pkwy
Ste G
Perry, GA 31069

1405 US Highway 82 W
Tifton, GA 31793
Phone (229) 388-0266

1430 US Highway 82 W
Ste 105
Tifton, GA 31793
Phone (229) 388-0266

3281 Inner Perimeter Rd
Valdosta, GA 31602
Phone (229) 671-9100

151 S Houston Lake Rd
Ste 190
Warner Robins, GA 31088
Phone (478) 400-1050

Interoperability endpoints

  • Direct secure messaging: jevans2806619@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 7

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1276128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432771200000",
    "number": "1942520093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4363",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312084363",
            "telephone_number": "478-787-4266",
            "fax_number": "478-787-4199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "770 WALNUT ST",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312017307",
            "telephone_number": "478-787-4266",
            "fax_number": "478-787-4199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "JENNIFER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-10",
        "last_updated": "2015-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "4152",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003134564A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Macon, GA

Sources for this page

Verify at the official NPI Registry.