Active NPI
Jennifer Wendy Freeman Fortier, CNM
- Advanced Practice Midwife
- Atlanta, GA
National Provider Identifier
1962632315
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Advanced Practice Midwife
- License
- RN 154520
- Practice address
- 2525 Cumberland Pkwy SE
Atlanta, GA 30339-3915 - Phone
- (404) 365-0966
- NPI assigned
- Jul 20, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Advanced Practice Midwife | 367A00000X | RN 154520 | GA | Primary |
Addresses
Primary practice location
2525 Cumberland Pkwy SE
Atlanta, GA 30339-3915
Mailing address
3495 Piedmont Rd NE
Atlanta, GA 30305-1717
Phone (404) 365-0966
Other names 1
- Jennifer Wendy Freeman
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepiceast.kp.org:14430/Interconnect-prodgam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq | 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: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Nurse Midwife
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN 154520 | GA | MD | Advanced Practice Midwife |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Southeast Permanente Medical Group | Advanced Practice Midwife | Current | Accepting new patients |
Locations
3495 Piedmont Rd NE
Bldg 9
Atlanta, GA 30305
Phone (404) 364-7000
2525 Cumberland Pkwy SE
Atlanta, GA 30339
Phone (770) 431-4145
Organizations & group practices 1
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.
-
- Internal Medicine Physician
- Atlanta, GA
- NPI 1245266956
Advanced Practice Midwife
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1248048000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1647907200000",
"number": "1962632315",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3495 PIEDMONT RD NE",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303051717",
"telephone_number": "404-365-0966"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2525 CUMBERLAND PKWY SE",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303393915",
"telephone_number": "404-365-0966"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FORTIER",
"first_name": "JENNIFER",
"middle_name": "WENDY FREEMAN",
"name_prefix": "Ms.",
"credential": "CNM",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-07-20",
"last_updated": "2022-03-22",
"certification_date": "2022-03-22",
"status": "A"
},
"taxonomies": [
{
"code": "367A00000X",
"taxonomy_group": "",
"desc": "Advanced Practice Midwife",
"state": "GA",
"license": "RN 154520",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodgam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
"affiliation": "N",
"endpointDescription": "Carequality",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "2525 Cumberland Pkwy SE",
"city": "Atlanta",
"state": "GA",
"country_code": "US",
"postal_code": "303393915",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "JENNIFER",
"last_name": "FREEMAN",
"middle_name": "WENDY",
"credential": "CNM",
"code": "5",
"type": "Other Name"
}
]
}
Other providers in Atlanta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2022; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.