Individual provider Active NPI

Jessica B. Glover, FNP-C

  • Pediatric Nurse Practitioner
  • Savannah, GA
National Provider Identifier
1093944316
Registry record updated Oct 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
RN217049 Issued in GA
Practice address
2 Wheeler St
Savannah, GA 31405
Phone
(912) 353-7744
Fax
(912) 355-9124
NPI assigned
Jul 8, 2009
Last updated
Oct 27, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2025

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 RN217049 GA
Family Nurse Practitioner 363LF0000X 3887 SC
Pediatric Nurse Practitioner 363LP0200X RN217049 GA Primary

Addresses

Primary practice location

2 Wheeler St
Savannah, GA 31405

Mailing address

2 Wheeler St
Savannah, GA 31405-5700
Phone (912) 353-7744

Other practice location 1

1000 Towne Center Blvd Ste 1000B
Pooler, GA 31322-4129
Phone (912) 353-7744

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
I20111128000802 GA Practitioner - Nurse Practitioner 7315136843 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3887SCMDFamily Nurse Practitioner
RN217049GAMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Minuteclinic LLC Family CurrentSince Oct 14, 2011 Accepting new patients
Coastal Pediatrics, LLC Past Accepting new patients
Coastal Pediatrics, LLC Past Accepting new patients

Locations

5095 Peachtree Pkwy
Norcross, GA 30092
Phone (770) 209-9299

11710 Alpharetta Hwy
Roswell, GA 30076
Phone (770) 754-0141

7207 Rockbridge Rd
Stone Mtn, GA 30087
Phone (770) 469-2002

Interoperability endpoints

  • Direct secure messaging: jessica.glover.1@8042.direct.athenahealth.com

Organizations & group practices 3

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": "1247011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761523200000",
    "number": "1093944316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 WHEELER ST",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314055700",
            "telephone_number": "912-353-7744",
            "fax_number": "912-355-9124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 WHEELER ST",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "31405",
            "telephone_number": "912-353-7744",
            "fax_number": "912-355-9124"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 Towne Center Blvd Ste 1000B",
            "address_purpose": "LOCATION",
            "city": "Pooler",
            "state": "GA",
            "postal_code": "313224129",
            "country_code": "US",
            "telephone_number": "912-353-7744",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GLOVER",
        "first_name": "JESSICA",
        "middle_name": "B.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-08",
        "last_updated": "2025-10-27",
        "certification_date": "2025-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN217049",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "3887",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "GA",
            "license": "RN217049",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Savannah, GA

Sources for this page

Verify at the official NPI Registry.