Individual provider Active NPI

Jimmequia Lanice Allen, MSN, APRN, FNP-C

  • Family Nurse Practitioner
  • Sylvester, GA
National Provider Identifier
1043826241
Registry record updated Sep 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN271383 Issued in GA
Practice address
304 N Westberry St
Sylvester, GA 31791-2125
Phone
(229) 463-7071
NPI assigned
Sep 22, 2020
Last updated
Sep 10, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN271383 GA Primary
Hospice Registered Nurse 163WH1000X RN271383 GA
Medical-Surgical Registered Nurse 163WM0705X RN271383 GA

Addresses

Primary practice location

304 N Westberry St
Sylvester, GA 31791-2125

Mailing address

4196 Highway 62 412 Ste a
Hardy, AR 72542-8002
Phone (912) 674-9370

Other practice location 1

117 James St
Woodbine, GA 31569-3568
Phone (912) 576-1967

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210112000366 GA Practitioner - Nurse Practitioner 6800209859 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN271383GAMDMedical-Surgical Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Pruitthealth Physicians Services, LLC Family CurrentSince Jan 12, 2026 Accepting new patients

Locations

1626 Jeurgens Ct
Norcross, GA 30093
Phone (770) 806-6875

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1600732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788998400000",
    "number": "1043826241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4196 HIGHWAY 62 412 STE A",
            "city": "HARDY",
            "state": "AR",
            "postal_code": "725428002",
            "telephone_number": "912-674-9370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 N WESTBERRY ST",
            "city": "SYLVESTER",
            "state": "GA",
            "postal_code": "317912125",
            "telephone_number": "229-463-7071"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "117 James St",
            "address_purpose": "LOCATION",
            "city": "Woodbine",
            "state": "GA",
            "postal_code": "315693568",
            "country_code": "US",
            "telephone_number": "912-576-1967",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ALLEN",
        "first_name": "JIMMEQUIA",
        "middle_name": "LANICE",
        "credential": "MSN, APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-22",
        "last_updated": "2026-09-10",
        "certification_date": "2026-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN271383",
            "primary": true
        },
        {
            "code": "163WH1000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Hospice",
            "state": "GA",
            "license": "RN271383",
            "primary": false
        },
        {
            "code": "163WM0705X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Medical-Surgical",
            "state": "GA",
            "license": "RN271383",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sylvester, GA

Sources for this page

Verify at the official NPI Registry.