Jasmine Darniece Kirkland, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP133880 Issued in TX

Practice address

6001 Professional Pkwy Ste 2020
Douglasville, GA 30134-5632

Phone

(470) 956-1570

NPI assigned

Jun 21, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

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, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Wellstar Medical Group LLCGroup PAC ID 6709065402, 3,059 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jkirkland417572@directwellstar.org

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.

• Wellstar Medical Group, LLC

  dba WellStar Family Medicine ACW

  • Family Medicine Physician
  • Kennesaw, GA
  • NPI 1558664003
  Medicare reassignment Care Compare group NPD
• Wellstar Medical Group, LLC

  • Multi-Specialty Clinic/Center
  • Marietta, GA
  • NPI 1275992240
  NPD

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

{
    "created_epoch": "1498003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624406400000",
    "number": "1952821936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6001 PROFESSIONAL PKWY STE 2020",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301345632",
            "telephone_number": "470-956-1570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6001 PROFESSIONAL PKWY STE 2020",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301345632",
            "telephone_number": "470-956-1570"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6400 Fannin St Ste 2800",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770301534",
            "country_code": "US",
            "telephone_number": "713-500-6128",
            "fax_number": "713-500-6128",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9180 Pinecroft Dr Ste 500",
            "address_purpose": "LOCATION",
            "city": "Shenandoah",
            "state": "TX",
            "postal_code": "773803883",
            "country_code": "US",
            "telephone_number": "713-897-5900",
            "fax_number": "713-897-2545",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9303 Pinecroft Dr Ste 270",
            "address_purpose": "LOCATION",
            "city": "The Woodlands",
            "state": "TX",
            "postal_code": "77380",
            "country_code": "US",
            "telephone_number": "713-897-5900",
            "fax_number": "713-897-2545",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIRKLAND",
        "first_name": "JASMINE",
        "middle_name": "DARNIECE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-21",
        "last_updated": "2021-06-23",
        "certification_date": "2021-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "23045",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP133880",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF TEXAS GRP REC #",
            "identifier": "0035TD",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "153449704",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Konfident Hair Clinic & Salon

• Family Nurse Practitioner in Douglasville, GA
• Providers in Douglasville, 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 Jun 23, 2021; 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.