Jordan H Weitzner, M.D.

Primary specialty

Pediatric Gastroenterology PhysicianTaxonomy code 2080P0206X

License

070003 Issued in GA

Practice address

2020 Cumming Hwy Ste 102
Canton, GA 30115-8071

Phone

(678) 593-1295

Fax

(678) 593-1294

NPI assigned

Jun 22, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• Aga, LLC

  • Gastroenterology Physician
  • Atlanta, GA
  • NPI 1124064118
  Medicare reassignment NPD
• Au Medical Associates Inc

  • Multi-Specialty Clinic/Center
  • Augusta, GA
  • NPI 1841230620
  Medicare reassignment NPD
• Au Medical Associates Inc

  • Durable Medical Equipment & Medical Supplies
  • Augusta, GA
  • NPI 1114574126
  NPD
• Scottish Rite Childrens Medical Ctr

  • Children's Hospital
  • Atlanta, GA
  • NPI 1922178789
  NPD (past)

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

{
    "created_epoch": "1277164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655251200000",
    "number": "1992026140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 CUMMING HWY STE 102",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301158071",
            "telephone_number": "678-593-1295",
            "fax_number": "678-593-1294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 CUMMING HWY STE 102",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301158071",
            "telephone_number": "678-593-1295",
            "fax_number": "678-593-1294"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1360 Caduceus Way Ste 101",
            "address_purpose": "LOCATION",
            "city": "Watkinsville",
            "state": "GA",
            "postal_code": "306777300",
            "country_code": "US",
            "telephone_number": "404-257-0799",
            "fax_number": "404-256-5475",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "316 W Pike St",
            "address_purpose": "LOCATION",
            "city": "Lawrenceville",
            "state": "GA",
            "postal_code": "300464878",
            "country_code": "US",
            "telephone_number": "404-257-0799",
            "fax_number": "404-256-5475",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "993 Johnson Fy Rd NE Ste D440",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303424780",
            "country_code": "US",
            "telephone_number": "404-257-0799",
            "fax_number": "404-256-5475",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WEITZNER",
        "first_name": "JORDAN",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-22",
        "last_updated": "2022-06-15",
        "certification_date": "2022-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "070003",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "4241",
            "primary": false
        },
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "GA",
            "license": "070003",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Weiner Eye Center, LLC
• Mark J Weiner, M.D.
• Eric Weinman, MD
• Lisa Gordon Weiss, PA-C
• Shannon Weist, LCSW
• Wellness Chiropractic Center
• Wellpharm LLC
• Wellstar Cardiovascular Medicine, LLC
• Wellstar Medical Group, LLC
• Wellstar Medical Group, LLC

• Pediatric Gastroenterology Physician in Canton, GA
• Providers in Canton, GA by specialty
• Pediatric Gastroenterology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 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.