Jessica Broth, FNP-C - Medicare Nurse Practitioner in Conyers, GA

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Jessica Broth, FNP-C is a medicare enrolled "Nurse Practitioner - Family" in Conyers, Georgia. Her current practice location is 1506 Klondike Rd Sw Ste 205, Conyers, Georgia. You can reach out to her office (for appointments etc.) via phone at (678) 750-4000.

Jessica Broth is licensed to practice in Georgia (license number RN175180) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1245985886.

Contact Information

Jessica Broth, FNP-C
1506 Klondike Rd Sw Ste 205,
Conyers, GA 30094-5173
(678) 750-4000
(678) 750-4005

Map and Direction




Provider's Profile

Full NameJessica Broth
GenderFemale
SpecialityNurse Practitioner - Family
Location1506 Klondike Rd Sw Ste 205, Conyers, Georgia
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1245985886
  • Provider Enumeration Date: 02/12/2022
  • Last Update Date: 03/01/2023
  Medicare PECOS Information:
  • PECOS PAC ID: 0042667453
  • Enrollment ID: I20231107001677

Medical Identifiers

Medical identifiers for Jessica Broth such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1245985886NPI-NPPES
003269528DMedicaidGA

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
163WL0100XRegistered Nurse - Lactation Consultant LC000233 (Georgia)Secondary
363LF0000XNurse Practitioner - Family RN175180 (Georgia)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Jessica Broth allows following entities to bill medicare on her behalf.
Entity NameThe Emory Clinic Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1396798229
PECOS PAC ID: 8820901408
Enrollment ID: O20031110000503

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jessica Broth is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Jessica Broth, FNP-C
1506 Klondike Rd Sw Ste 205,
Conyers, GA 30094-5173

Ph: (678) 750-4000		Jessica Broth, FNP-C
1506 Klondike Rd Sw Ste 205,
Conyers, GA 30094-5173

Ph: (678) 750-4000

Reviews and Comments


Nurse Practitioner Nurses in Conyers, GA

Turquoise Allen,
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 1506 Klondike Rd Sw Ste 403, Conyers, GA 30094
Phone: 770-285-6699    Fax: 770-285-6510
Cecelin E Fields,
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 1706 Woodstone Cv Se, Conyers, GA 30013
Phone: 770-688-0405    
Assumpta Ogbedeagu, MS-FNP-C
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 2920 Highway 138 Ne, Conyers, GA 30013
Phone: 303-214-8017    
Mrs. Diana Kimbrough, PMHNP
Nurse Practitioner
Medicare: Not Enrolled in Medicare
Practice Location: 911 Chambers Dr Nw, Conyers, GA 30012
Phone: 770-278-8171    
Meetali Bindra, NP
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 1288 Wellbrook Cir Ne Ste A, Conyers, GA 30012
Phone: 678-369-6934    
Ms. Judith T Chabot, FNP-C
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 425 Sigman Rd Nw, Suite 109, Conyers, GA 30012
Phone: 678-413-2026    Fax: 678-413-2030
Nathalie G Bailey, NP-C
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 1280 Dogwood Dr Se, Conyers, GA 30013
Phone: 404-994-4662    

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.