DR. JENNIFER BETH AQUA (NPI# 1770512675) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770512675 |
| Entity Type | Individual |
| Full Name | DR. JENNIFER BETH AQUA |
| Credential | MD |
| Practice Address |
960 Johnson Ferry Rd Ne Ste 400 Atlanta GA 30342-4771 |
| Practice Telephone | 4042570170 |
| Practice Fax Number | 4048519894 |
| Mailing Telephone | 4042570170 |
| Mailing Fax Number | 4048519894 |
| Enumeration Date | 2006-07-02 |
| Last Update Date | 2011-11-29 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | 044882 | GA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 000804273W | 05 | |
| GA | 00804273U | 05 | |
| GA | UNITED HEALTHCARE | 0701009 | 01 |
| GA | 000804273V | 05 | |
| GA | RAILROAD MEDICARE | 160052432 | 01 |
| GA | 00804273R | 05 | |
| GA | BLUE CROSS BLUE SHIELD | 013526 | 01 |
| GA | AETNA/USHC | 2624404 | 01 |
| GA | AETNA/USHC | 5857673 | 01 |
| Street Address |
960 JOHNSON FERRY RD NE STE 400 |
| City | ATLANTA |
| State | GA |
| Zip Code | 30342-4771 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033112198 | Alan I Segal | Audiologist | 960 Johnson Ferry Rd Ne, Ste 200, Atlanta, GA 30342-1631 | 2005-05-23 |
| 1245628957 | Maryann Reuben | Specialist/Technologist, Other | 960 Johnson Ferry Rd Ne, Suite 120, Atlanta, GA 30342 | 2015-01-05 |
| 1679917835 | Comprehensive Internal Medicine At Northside | Internal Medicine | 960 Johnson Ferry Rd Ne, Suite 543, Atlanta, GA 30342-1631 | 2013-04-18 |
| 1881957553 | Allison M Sugg | Physician Assistant | 960 Johnson Ferry Rd Ne, Suite 200, Atlanta, GA 30342-1631 | 2012-06-19 |
| 1922392190 | Center for Pediatric Wellness, P.C. | Pediatrics | 960 Johnson Ferry Rd Ne, Suite 315, Atlanta, GA 30342-1631 | 2011-06-06 |
| 1780910737 | Faraa Mobini | Physician Assistant | 960 Johnson Ferry Rd Ne, Suite 200, Atlanta, GA 30342-1631 | 2009-10-27 |
| 1376779322 | Village Podiatry Group, P.C. | Podiatrist | 960 Johnson Ferry Rd Ne, Suite 310, Atlanta, GA 30342-1631 | 2009-06-04 |
| 1255597282 | Plastic Surgery Institute of Atlanta, P.C. | Plastic Surgery | 960 Johnson Ferry Rd Ne, Suite 245, Atlanta, GA 30342-1631 | 2008-07-30 |
| 1912165382 | Mervyn B Forman Md, L.l.c | Internal Medicine | 960 Johnson Ferry Rd Ne, Ste 530, Atlanta, GA 30342-1631 | 2008-06-02 |
| 1275722811 | Raymond V. Caputo, M.d.,p.c. | Dermatology | 960 Johnson Ferry Rd Ne, Suite 226, Atlanta, GA 30342-1631 | 2007-10-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144820614 | Nia Charnice Griffin | Nurse Practitioner | 5670 Peachtree Dunwoodyroad, Suite 900, Atlanta, GA 30342 | 2020-10-26 |
| 1255945184 | Jennifer Lynne Cole | Behavior Technician | 5555 Glenridge Con Suite 200, Atlanta, GA 30342 | 2020-09-08 |
| 1093336232 | Van Tran | Respiratory Therapist, Registered | 1000 Johnson Ferry Rd Ne, Atlanta, Ga 30342, Atlanta, GA 30342 | 2020-04-28 |
| 1356978340 | Twyla Douglas Jackson I | Clinical Nutrition, 1000 Johnson Ferry Rd Ne, Atlanta, GA 30342 | 2020-03-27 | |
| 1760013411 | Emily Hamm | Dietitian, Registered | 933 D Johnson Ferry Road, Suite 250, Atlanta, GA 30342 | 2020-01-31 |
| 1043855984 | Mackenzie Tucker Wayda | Registered Nurse | 1001 Johnson Ferry Rd. Ne, Atlanta, GA 30342 | 2019-11-14 |
| 1386288454 | Tiauna Lashun Cochman | Psychologist | 1307 Glenridge Dr, Sandy Springs, GA 30342 | 2019-11-01 |
| 1164074399 | Stephen J. White | Hearing Instrument Specialist | 5775 Peachtree Dunwoody Rd Suite 600 Fl. 6, Uhc Hearing, Atl., GA 30342 | 2019-07-09 |
| 1144788142 | Jaytyn LLC | Internal Medicine | 4600 Broswell Road, Atlanta, GA 30342 | 2019-03-08 |
| 1760954705 | Mishele Walker LLC | Counselor | 555 Glenridge Connector, Suite 200, Sandy Springs, GA 30342 | 2018-12-31 |
| Find all providers in zip 30342 | ||||
| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477185221 | Metro Health and Wellness, LLC | Obstetrics & Gynecology | 2950 Stone Hogan Connector Rd Sw Bldg B, Atlanta, GA 30331-2837 | 2020-02-10 |
| 1518464353 | Naws Piedmont, LLC | Obstetrics & Gynecology | 1800 Peachtree St Nw Ste 455, Atlanta, GA 30309-2520 | 2018-04-09 |
| 1174039127 | Karen Hoover | Obstetrics & Gynecology | 1600 Clifton Rd Ne # Mse45, Atlanta, GA 30329-4018 | 2017-12-28 |
| 1659733228 | Cantey Hattink Dogan | Obstetrics & Gynecology | 275 Collier Rd Nw Ste 100a, Atlanta, GA 30309-1700 | 2016-03-23 |
| 1245617505 | Danielle Mccarthur | Obstetrics & Gynecology | 550 Peachtree St Ne Ste 1470, Atlanta, GA 30308 | 2015-05-06 |
| 1316358484 | Graysan Kirk Southern | Obstetrics & Gynecology | 69 Jesse Hill Jr Dr Se Rm 410, Atlanta, GA 30303-3033 | 2014-05-12 |
| 1558781161 | Cunningham and Associates, LLC | Obstetrics & Gynecology | 325 Hammond Dr, Suite 201, Atlanta, GA 30328-5032 | 2014-04-22 |
| 1538507199 | Yeonjung Park | Obstetrics & Gynecology | 5780 Peachtree Dunwoody Rd Ste 200, Atlanta, GA 30342-1558 | 2013-06-05 |
| 1487997664 | Jennifer K Gustafson | Obstetrics & Gynecology | 5673 Peachtree Dunwoody Rd Ste 700, Atlanta, GA 30342-1752 | 2013-04-05 |
| 1194068197 | Jaclyn Friedman | Obstetrics & Gynecology | 960 Johnson Fy Rd Ne Ste 400, Atlanta, GA 30342-4771 | 2013-03-28 |
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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.