Individual provider Active NPI

Jennifer V Dobbs

  • Case Manager/Care Coordinator
  • Bremen, GA
National Provider Identifier
1063763993
Registry record updated Oct 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
License
BCW SC Issued in GA
Practice address
194 Charleston Ave
Bremen, GA 30110-7913
Phone
(770) 328-1736
NPI assigned
Oct 2, 2012
Last updated
Oct 2, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 2, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X BCW SC GA Primary

Addresses

Primary practice location

194 Charleston Ave
Bremen, GA 30110-7913

Mailing address

194 Charleston Ave
Bremen, GA 30110-7913
Phone (770) 328-1736

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
BCW SCGAMDCase Manager/Care Coordinator

NPI Registry JSON

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

{
    "created_epoch": "1349136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349136000000",
    "number": "1063763993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "194 CHARLESTON AVE",
            "city": "BREMEN",
            "state": "GA",
            "postal_code": "301107913",
            "telephone_number": "770-328-1736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "194 CHARLESTON AVE",
            "city": "BREMEN",
            "state": "GA",
            "postal_code": "301107913",
            "telephone_number": "770-328-1736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOBBS",
        "first_name": "JENNIFER",
        "middle_name": "V",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-02",
        "last_updated": "2012-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "GA",
            "license": "BCW SC",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bremen, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.