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MAGNOLIA ENT, LLC
NPI 1720828395
Otolaryngology in Peachtree City, GA

Active since May 30, 2024
1000 COMMERCE DR STE 200, PEACHTREE CITY, GA 30269(470) 489-0090(470) 489-0090 Get Directions Write a Review

NPPES record last updated: June 27, 2024. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Magnolia Ent, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MAGNOLIA ENT, LLC (NPI 1720828395) is a healthcare organization registered as an otolaryngology in Peachtree City, Georgia and active in the NPI registry since May 2024. The organization maintains 4 additional practice locations and lists Nancy H Jennings, Partner, as its authorized official.

NPPES Registry Identity

NPI1720828395
Entity TypeOrganization
Primary Taxonomy207Y00000X
Legal Business NameMAGNOLIA ENT, LLC
Location Address1000 COMMERCE DR STE 200Peachtree City, GA 30269-3520
Mailing Address1000 Commerce Dr Ste 200Peachtree City, GA 30269-3520 · (404) 725-8786 · Fax (770) 615-5017
Phone(470) 489-0090
Fax(470) 489-0090
Organization SubpartNo
Authorized OfficialNancy H JenningsPartner · (678) 427-1499
Enumeration DateMay 30, 2024
Last NPPES UpdateJune 27, 2024
NPPES CertifiedJune 27, 2024
✔ NPI 1720828395 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOtolaryngologyAllopathic & Osteopathic Physicians
Taxonomy Code207Y00000X
Definition
An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise.
1000 COMMERCE DR STE 200, Peachtree City, GA 30269
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Secondary Practice Locations 4

Location 11015 Lafayette Pkwy Ste 130LaGrange, GA 30241-3584 · Phone (470) 489-0090 · Fax (470) 489-0090
Location 21365 Rock Quarry Rd Ste 300Stockbridge, GA 30281-5024 · Phone (470) 489-0090 · Fax (470) 489-0090
Location 320 Francis WaySharpsburg, GA 30277-3589 · Phone (470) 489-0090 · Fax (470) 489-0090
Location 41595 Highway 34 ENewnan, GA 30265-2353 · Phone (470) 489-0090 · Fax (470) 489-0090

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Magnolia Ent, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

14

Medicare enrollment records show 14 clinicians reassign Medicare billing to Magnolia Ent, LLC, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 4 within 10 miles. They are listed nearest first.

Clinicians by Medicare Specialty 4

Nurse Practitioner6
Qualified Audiologist4
Otolaryngology3
Physical Therapist in Private Practice1

Clinicians, nearest first (14)

Mischelle Hardwick, DPT
Physical Therapist in Private Practice
NPI 1598727760
1000 COMMERCE DR STE 200
Peachtree City, GA 30269
(770) 740-1860
✔ Accepts MedicareSame address
Carol Johnson, NP
Nurse Practitioner
NPI 1548680127
2305 HIGHWAY 34 E
Newnan, GA 30265
(866) 389-2727
✔ PECOS✔ Accepts Medicare6.7 mi
George Livermore, M.D.
Otolaryngology
NPI 1528046919
1595 HIGHWAY 34 E
Newnan, GA 30265
(678) 206-2202
✔ PECOS✔ Accepts Medicare7.8 mi
Alexandria Port
Nurse Practitioner
NPI 1447114905
1595 GA-34 E
Newnan, GA 30265
(470) 489-0090
✔ PECOS✔ Accepts Medicare7.8 mi
Matthew Karen, MD
Otolaryngology
NPI 1477519833
1365 ROCK QUARRY RD STE 300
Stockbridge, GA 30281
(770) 740-1860
✔ PECOS✔ Accepts Medicare22 mi
Tina Jordan, FNP
Nurse Practitioner
NPI 1255703088
4631 BILL GARDNER PKWY
Locust Grove, GA 30248
(770) 630-6281
✔ PECOS✔ Accepts Medicare27 mi
Brandii Smith, FNP
Nurse Practitioner
NPI 1881302883
865 N HIGHLAND AVE NE
Atlanta, GA 30306
(404) 733-6089
✔ PECOS29 mi
Natalie Griffin
Nurse Practitioner
NPI 1699573527
2675 PACES FERRY RD SE STE 200
Atlanta, GA 30339
(404) 641-6645
✔ PECOS✔ Accepts Medicare33 mi
Emily Slay, APRN
Nurse Practitioner
NPI 1831735547
303 SMITH ST
Lagrange, GA 30240
(706) 882-8831
✔ PECOS✔ Accepts Medicare36 mi
Ericka Tucker, M.S.CCC-A
Qualified Audiologist
NPI 1265670988
2365 OLD MILTON PKWY SUITE 200
Alpharetta, GA 30009
(678) 825-2469
✔ Accepts Medicare49 mi
Kristie Reeves, AU.D. CCC-A
Qualified Audiologist
NPI 1144272147
2445 TAMPA RD STE H
Palm Harbor, FL 34683
(800) 277-1182
✔ Accepts Medicare383 mi
Lindsey Banks, AU. D
Qualified Audiologist
NPI 1558672352
1010 OLD DES PERES RD
Saint Louis, MO 63131
(314) 729-0077
✔ Accepts Medicare486 mi
Stephanie Moore, AUD
Qualified Audiologist
NPI 1205941804
4100 SE ADAMS RD STE C106
Bartlesville, OK 74006
(918) 333-9992
✔ Accepts Medicare682 mi
Myles Kessler, AUD
Otolaryngology
NPI 1649320102
46 PRINCE ST STE 6
New Haven, CT 06519
(203) 752-1726
✔ PECOS✔ Accepts Medicare841 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Magnolia Ent, LLC's NPI number?

The NPI number for Magnolia Ent, LLC is 1720828395. It was assigned to this organization in the NPPES registry on May 30, 2024.

Where is Magnolia Ent, LLC located?

Magnolia Ent, LLC is located at 1000 Commerce Dr Ste 200, Peachtree City, GA 30269. The listed phone number is (470) 489-0090.

What is Magnolia Ent, LLC's specialty?

The primary specialty registered for this NPI is Otolaryngology with taxonomy code 207Y00000X.

Is Magnolia Ent, LLC enrolled in Medicare?

Yes. Magnolia Ent, LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Magnolia Ent, LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 14 clinicians in 4 Medicare specialties reassign their Medicare billing to Magnolia Ent, LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (6), Qualified Audiologist (4) and Otolaryngology (3). Of these, 1 practice at this address and 4 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Magnolia Ent, LLC was last updated on June 27, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.