Individual provider Active NPI

Jennifer Lynn Parrish, NP-C

  • Family Nurse Practitioner
  • Moultrie, GA
National Provider Identifier
1952786006
Registry record updated Jun 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN166663 Issued in GA
Practice address
358 Veterans Pkwy N
Moultrie, GA 31788-4171
Phone
(229) 891-3513
Fax
(229) 890-1986
NPI assigned
Jul 29, 2015
Last updated
Jun 27, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN166663 GA Primary

Addresses

Primary practice location

358 Veterans Pkwy N
Moultrie, GA 31788-4171

Mailing address

358 Veterans Pkwy N
Moultrie, GA 31788-4171
Phone (229) 891-3513

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
I20151001002731 GA Practitioner - Nurse Practitioner 2567770019 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SGMC Physician Network IncGroup PAC ID 4082036843, 128 clinicians

Practice addresses (Care Compare)

4274 N Valdosta Rd
Valdosta, GA 31602-6814
Phone (229) 242-1234

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN166663GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
SGMC Affiliated Services LLC Current Accepting new patients
SGMC Physician Network Inc CurrentSince Sep 1, 2025 Accepting new patients

Locations

4274 N Valdosta Rd
Valdosta, GA 31602
Phone (229) 242-1234

4280 N Valdosta Rd
Valdosta, GA 31602
Phone (229) 433-7350

Organizations & group practices 2

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": "1438128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687824000000",
    "number": "1952786006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "358 VETERANS PKWY N",
            "city": "MOULTRIE",
            "state": "GA",
            "postal_code": "317884171",
            "telephone_number": "229-891-3513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "358 VETERANS PKWY N",
            "city": "MOULTRIE",
            "state": "GA",
            "postal_code": "317884171",
            "telephone_number": "229-891-3513",
            "fax_number": "229-890-1986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARRISH",
        "first_name": "JENNIFER",
        "middle_name": "LYNN",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-29",
        "last_updated": "2023-06-27",
        "certification_date": "2023-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN166663",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moultrie, GA

Sources for this page

Verify at the official NPI Registry.