Individual provider Active NPI

Jessica N Dunn, ARNP

  • Pediatric Nurse Practitioner
  • Villa Rica, GA
National Provider Identifier
1952653040
Registry record updated Jul 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
RN281925 Issued in GA
Practice address
626 Dallas Hwy
Villa Rica, GA 30180
Phone
(770) 459-9378
Fax
(770) 459-8613
NPI assigned
Oct 12, 2012
Last updated
Jul 12, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X ARNP9347511 FL
Pediatric Nurse Practitioner 363LP0200X RN281925 GA Primary

Addresses

Primary practice location

626 Dallas Hwy
Villa Rica, GA 30180

Mailing address

626 Dallas Hwy
Villa Rica, GA 30180-1209
Phone (770) 459-9378

Other practice location 1

51 Hiram Dr Bldg B
Hiram, GA 30141-1844
Phone (678) 945-8300

Other practice location 2

410 N Main St
Suite A & B
Chiefland, FL 32626-0866
Phone (352) 493-7274

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jdunn521270@directwellstar.org Health Information Exchange (HIE)

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
I20230421000756 GA Practitioner - Nurse Practitioner 8325367006 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wellstar Medical Group, LLC CurrentSince May 1, 2023 Accepting new patients
Wellstar Medical Group, LLC Current Accepting new patients
Westcare Villa Rica Pediatrics Past Accepting new patients

Locations

51 Hiram Dr
Bldg B
Hiram, GA 30141
Phone (678) 945-8300

5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222

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": "1350000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689120000000",
    "number": "1952653040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "626 DALLAS HWY",
            "city": "VILLA RICA",
            "state": "GA",
            "postal_code": "301801209",
            "telephone_number": "770-459-9378",
            "fax_number": "770-459-8613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "626 DALLAS HWY",
            "city": "VILLA RICA",
            "state": "GA",
            "postal_code": "30180",
            "telephone_number": "770-459-9378",
            "fax_number": "770-459-8613"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "51 Hiram Dr Bldg B",
            "address_purpose": "LOCATION",
            "city": "Hiram",
            "state": "GA",
            "postal_code": "301411844",
            "country_code": "US",
            "telephone_number": "678-945-8300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "410 N Main St",
            "address_2": "Suite A & B",
            "address_purpose": "LOCATION",
            "city": "Chiefland",
            "state": "FL",
            "postal_code": "326260866",
            "country_code": "US",
            "telephone_number": "352-493-7274",
            "fax_number": "352-463-2726",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DUNN",
        "first_name": "JESSICA",
        "middle_name": "N",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-12",
        "last_updated": "2023-07-12",
        "certification_date": "2023-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "ARNP9347511",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "GA",
            "license": "RN281925",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jdunn521270@directwellstar.org",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "51 Hiram Dr Bldg B",
            "city": "Hiram",
            "state": "GA",
            "country_code": "US",
            "postal_code": "301411844",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Villa Rica, GA

Sources for this page

Verify at the official NPI Registry.