Jennifer Yvette Reddick, NURSE PRACTITIONER

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

RN210487 Issued in GA

Practice address

3985 Sharon SPGS
Powder Springs, GA 30127-2846

Phone

(786) 431-7637

NPI assigned

Nov 29, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Signify Health Medical Associates, PLLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1750845863

  GA

  Medicare reassignment NPD

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

{
    "created_epoch": "1606608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670630400000",
    "number": "1982208054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3985 SHARON SPGS",
            "city": "POWDER SPRINGS",
            "state": "GA",
            "postal_code": "301272846",
            "telephone_number": "786-431-7637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3985 SHARON SPGS",
            "city": "POWDER SPRINGS",
            "state": "GA",
            "postal_code": "301272846",
            "telephone_number": "786-431-7637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDDICK",
        "first_name": "JENNIFER",
        "middle_name": "YVETTE",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-29",
        "last_updated": "2022-12-10",
        "certification_date": "2022-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "GA",
            "license": "RN210487",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GA",
            "license": "RN210487",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ra Health Group LLC
• Chidambaram Raghavan, MD
• Jamie Ranieri
• Mariya K Ransom, RN
• Sheila R Rector, RN
• Tiffany Reddick, L.P.C.
• Rediclinic LLC
• Kayla Reeder
• Reliable Homecare of Georgia,LLC
• Renal Treatment Centers - Mid-Atlantic, Inc. (Macland Dialysis)

• Registered Nurse in Powder Springs, GA
• Providers in Powder Springs, GA by specialty
• Registered Nurse in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 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.

Verify at the official NPI Registry.