JEFFREY LEE JENNELL (NPI# 1194039388) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194039388 |
| Entity Type | Individual |
| Full Name | JEFFREY LEE JENNELL |
| Practice Address |
1 Freedom Way Augusta GA 30904-6258 |
| Practice Telephone | 7067330188 |
| Practice Fax Number | 7064816703 |
| Mailing Telephone | 7067330188 |
| Mailing Fax Number | 7064816703 |
| Enumeration Date | 2010-07-30 |
| Last Update Date | 2010-07-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 156FX1100X |
Technician/Technologist Specialization: Ophthalmic |
Eye and Vision Services Providers |
| Street Address |
1 FREEDOM WAY |
| City | AUGUSTA |
| State | GA |
| Zip Code | 30904-6258 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912900713 | Robert Leon Longe | Pharmacist | 1 Freedom Way, Augusta, GA 30904-6258 | 2005-05-24 |
| 1609476951 | Melissa Ann Cotton | Dentist | 1 Freedom Way, Augusta, GA 30904-6258 | 2020-10-27 |
| 1487253217 | Kelsey Shull | Recreation Therapist | 1 Freedom Way, Augusta, GA 30904-6258 | 2020-10-22 |
| 1437758844 | Angela Marie Brown | Social Worker | 1 Freedom Way, Augusta, GA 30904-6258 | 2020-10-19 |
| 1538767819 | Stephen William Montgomery | Music Therapist | 1 Freedom Way, Augusta, GA 30904-6258 | 2020-10-09 |
| 1134726631 | Rebecca Leigh Halioua | Recreation Therapist | 1 Freedom Way, Augusta, GA 30904-6258 | 2020-10-07 |
| 1104435718 | Vincent Michael Fitch | Psychologist | 1 Freedom Way, Augusta, GA 30904-6258 | 2020-07-29 |
| 1558988162 | Amanda Draheim | Psychologist | 1 Freedom Way, Augusta, GA 30904-6258 | 2020-06-30 |
| 1174140784 | Tiffany Ariel Graves | Student in an Organized Health Care Education/Training Program | 1 Freedom Way, Augusta, GA 30904-6258 | 2020-06-30 |
| 1982221776 | Janice J Anglin | Dietitian, Registered | 1 Freedom Way, Augusta, GA 30904-6258 | 2020-06-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518423706 | Lawren Murray Tachias | Registered Nurse | 950 15th Street Downtown, Augusta, GA 30904 | 2019-02-13 |
| 1457851842 | Heba Ahmed | Pharmacist | 912 15th Street, Augusta, GA 30904 | 2018-02-13 |
| 1124552690 | Jenny Liles | Student in an Organized Health Care Education/Training Program | 1004 Chafee Ave, Augusta, GA 30904 | 2017-04-11 |
| 1932640836 | Claudia Crawford | Student in an Organized Health Care Education/Training Program | 2624 Oakland Ave., Augusta, GA 30904 | 2017-03-13 |
| 1801240528 | F. Marion Durst IIi Dmd PC | Clinic/Center | 2325 Washington Road, Augusta, GA 30904 | 2016-04-19 |
| 1689031296 | Teresa Maria Martin | Counselor | 1e-148, Charlie Norwood Vamc One Freedom Way, Augusta, GA 30904 | 2016-01-27 |
| 1598122269 | Jillian Wilkerson | Counselor | Charlie Norwood Veteran Affairs One Freedom Way, Substance Use Recovery Clinic, Augusta, GA 30904 | 2016-01-26 |
| 1760855241 | Chase King | Occupational Therapist | 1735 Berkeley Rd, Augusta, GA 30904 | 2015-11-05 |
| 1962832246 | April Underwood Fox | Physician Assistant | 1417 Pendleton Rd, Augusta, GA 30904 | 2013-11-22 |
| 1861734378 | John Graham Theisen | Obstetrics & Gynecology | 810 Chafee Avenue, Augusta, GA 30904 | 2013-03-22 |
| Find all providers in zip 30904 | ||||
| Taxonomy Code | 156FX1100X |
| Grouping | Eye and Vision Services Providers |
| Classification | Technician/Technologist |
| Specialization | Ophthalmic |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356999130 | Anna Mccaskill | Technician/Technologist | 1890 Browning Bend Ct, Dacula, GA 30019-7771 | 2019-08-26 |
| 1093221541 | Jessica Leigh Smith | Technician/Technologist | 439 Fir Rd, Franklin, GA 30217-3976 | 2017-12-20 |
| 1134587801 | Robert Pierpont Taylor | Technician/Technologist | 321 Chinquapin Dr Sw, Marietta, GA 30064-3505 | 2016-02-09 |
| 1801059175 | East Point Eye Clinic PC | Technician/Technologist | 3600 Marketplace Blvd, East Point, GA 30344-8129 | 2008-07-08 |
| 1437352812 | Choi Eye Institute, P.C. | Technician/Technologist | 1107 Memorial Dr, Suite 102, Dalton, GA 30720-8662 | 2007-06-06 |
| 1801956909 | Dixophthal PC | Technician/Technologist | 806 N Jefferson St, Albany, GA 31701-2363 | 2006-12-11 |
| 1710066048 | Dean A Sheldon | Technician/Technologist | 1670 Clairmont Rd, Decatur, GA 30033-4004 | 2006-11-06 |
| 1538271820 | Donna N Loupe | Technician/Technologist | 1670 Clairmont Rd, Decatur, GA 30033-4004 | 2006-08-31 |
| 1851308381 | Stephen H Herman | Technician/Technologist | 1670 Clairmont Rd, Decatur, GA 30033-4004 | 2006-08-01 |
| 1225045495 | Michael Allan Schrage | Technician/Technologist | 1670 Clairmont Rd, Optical Shop 1c 184, Decatur, GA 30033-4004 | 2006-08-01 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.