Jennifer B Sissom (NPI# 1063488708, PAC ID# 8527039924) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICIAN ASSISTANT.
| Nation Provider ID (NPI) | 1063488708 |
| PAC ID by PECOS | 8527039924 |
| Professional Enrollment ID | I20040802000043 |
| Full Name | Jennifer B Sissom |
| Organization Legal Name | GWINNETT DERMATOLOGY, PC D/B/A GEORGIA DERMATOLOGY PARTNERS |
| Address |
2383 Pate St Snellville GA 30078-3250 |
| Phone Number | 7709724845 |
| Gender | F |
| Credential | PA |
| Medical School | EMORY UNIVERSITY SCHOOL OF MEDICINE |
| Graduation Year | 2003 |
| Primary Specialty | PHYSICIAN ASSISTANT |
| Group Practice PAC ID | 6002804309 |
| Number of Group Practice Members | 13 |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| River Place Medical Plaza, 1 1515 River Place Suite 300, Braselton, GA 30517-5605 | 7709724845 | GWINNETT DERMATOLOGY, PC D/B/A GEORGIA DERMATOLOGY PARTNERS |
| 2383 Pate St, Snellville, GA 30078-3250 | 7709724845 | GWINNETT DERMATOLOGY, PC D/B/A GEORGIA DERMATOLOGY PARTNERS |
| Measure Identifier | Measure Title | Performance Rate | Reporting Mechanism |
|---|---|---|---|
| ACI_EC_TRANS_PHCDRR_3 | Specialized Registry Reporting | % | |
| ACI_EC_TRANS_PPHI_1 | Security Risk Analysis | % | |
| MIPS_EC_137_overall | Melanoma: Continuity of Care - Recall System | 96% | |
| MIPS_EC_224_overall | Melanoma: Overutilization of Imaging Studies in Melanoma | 100% | |
| MIPS_EC_238_2+ | Use of High-Risk Medications in the Elderly (100%: worst, 0% best) | 0% | |
| MIPS_EC_238_overall | Use of High-Risk Medications in the Elderly (100%: worst, 0% best) | 0% |
| Organization Legal Name | GWINNETT DERMATOLOGY, PC D/B/A GEORGIA DERMATOLOGY PARTNERS |
| Physicians | 11 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Kirk D Saddler | Dermatology | Gwinnett Dermatology, PC D/b/a Georgia Dermatology Partners | 117 Lee Byrd Rd, Loganville, GA 30052-2310 |
| Susan B Oh | Dermatology | Gwinnett Dermatology, PC D/b/a Georgia Dermatology Partners | 2383 Pate St, Snellville, GA 30078-3250 |
| Joel S Shavin | Dermatology | Gwinnett Dermatology, PC D/b/a Georgia Dermatology Partners | 2383 Pate St, Snellville, GA 30078-3250 |
| Amy K Goodman | Physician Assistant | Gwinnett Dermatology, PC D/b/a Georgia Dermatology Partners | 117 Lee Byrd Rd, Loganville, GA 30052-2310 |
| Jessica J Mercer | Pathology | Gwinnett Dermatology, PC D/b/a Georgia Dermatology Partners | 117 Lee Byrd Rd, Loganville, GA 30052-2310 |
| Keith Wright | Dermatology | Gwinnett Dermatology, PC D/b/a Georgia Dermatology Partners | 117 Lee Byrd Rd, Loganville, GA 30052-2310 |
| Alia Brown | Dermatology | Gwinnett Dermatology, PC D/b/a Georgia Dermatology Partners | 117 Lee Byrd Rd, Loganville, GA 30052-2310 |
| Devon Pattillo | Physician Assistant | Gwinnett Dermatology, PC D/b/a Georgia Dermatology Partners | 2383 Pate St, Snellville, GA 30078-3250 |
| Brittany Dupree | Nurse Practitioner | Gwinnett Dermatology, PC D/b/a Georgia Dermatology Partners | 117 Lee Byrd Rd, Loganville, GA 30052-2310 |
| Courtney Renner Davis | Physician Assistant | Gwinnett Dermatology, PC D/b/a Georgia Dermatology Partners | 117 Lee Byrd Rd, Loganville, GA 30052-2310 |
| Street Address |
2383 PATE ST |
| City | SNELLVILLE |
| State | GA |
| Zip | 30078-3250 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Susan B Oh | Dermatology | Gwinnett Dermatology, PC D/b/a Georgia Dermatology Partners | 2383 Pate St, Snellville, GA 30078-3250 |
| Joel S Shavin | Dermatology | Gwinnett Dermatology, PC D/b/a Georgia Dermatology Partners | 2383 Pate St, Snellville, GA 30078-3250 |
| Devon Pattillo | Physician Assistant | Gwinnett Dermatology, PC D/b/a Georgia Dermatology Partners | 2383 Pate St, Snellville, GA 30078-3250 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Ashley Ann Mire | Certified Registered Nurse Anesthetist (crna) | Premier Anesthesia of Georgia LLC | 1700 Medical Ctr Way, Snellville, GA 30078 |
| Ramanjaneyulu V Dronavalli | Internal Medicine | 2138 Scenic N Hwy A, Snellville, GA 30078 | |
| Jody Meek | Anesthesiology Assistant | Premier Anesthesia of Georgia LLC | 1700 Medical Ctr Way, Snellville, GA 30078 |
| Brittany E Bradley | Certified Registered Nurse Anesthetist (crna) | Premier Anesthesia of Georgia LLC | 1700 Medical Ctr Way, Snellville, GA 30078 |
| Keith Alan Housman | Anesthesiology | Premier Anesthesia of Georgia LLC | 1700 Medical Ctr Way, Snellville, GA 30078 |
| Thien D Quach | Anesthesiology | Premier Anesthesia of Georgia LLC | 1700 Medical Ctr Way, Snellville, GA 30078 |
| Benjamin Lee Hicks | Anesthesiology Assistant | Premier Anesthesia of Georgia LLC | 1700 Medical Ctr Way, Snellville, GA 30078 |
| Geetha Jonnala | Rheumatology | 1567 Janmar Rd, Suite 100, Snellville, GA 30078-0308 | |
| Oyinkansola Akinmade | Physical Therapy | Caretherapy, LLC | 1567 Janmar Rd, Snellville, GA 30078-0309 |
| Allison L Guisasola | Occupational Therapy | Caretherapy, LLC | 1567 Janmar Rd, Snellville, GA 30078-0309 |
| Find all physicians in zip 30078 | |||
| City | SNELLVILLE |
| Zip Code | 30078 |
| Specialty | PHYSICIAN ASSISTANT |
| City + Specialty | SNELLVILLE + PHYSICIAN ASSISTANT |
Please comment or provide details below to improve the information on Jennifer B Sissom.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.