JADE ELIZABETH FUNCK (DO) – Family Medicine Physician, NPI 1396485355
Family Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
3,103 FAMILY PRACTICE in GA
Provider Addresses for JADE ELIZABETH FUNCK (DO)
301 Broad Street
Wrens, GA 30833
Phone: (706) 547-2559
Type: Location
2050 Walton Way
Augusta, GA 309042305
Phone: (706) 434-1590
Type: Location
1115 Garredd Blvd
Augusta, GA 309096758
Phone: (706) 922-4620
Type: Location
332 LAUREL ST
HAZARD, KY 417011720
Phone: (504) 914-9258
Type: Mailing
4461 STATE ROUTE 159 STE A
CHILLICOTHE, OH 456016000
Phone: (740) 779-4900
Type: Location
2467 GOLDEN CAMP RD
AUGUSTA, GA 309065515
Phone: (706) 790-4440
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2025-08-08
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20250808002294 | I | Family Practice | GA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 30833)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | GA | |
| General Practice | FL | |
| O B S T E T R I C S/ G Y N E C O L O G Y | GA | |
| General Practice | GA | |
| Family Practice, Emergency Medicine | GA | |
| A L L E R G Y/ I M M U N O L O G Y | GA | |
| Physician Assistant | GA | |
| Clinical Social Worker | GA | |
| Nurse Practitioner | GA | |
| Physician Assistant | GA |
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