Jimmie Lee Fowler III, RN
Individual provider Active NPI Case Management Agency · Colbert, GA
NPI 1124984166 · NPPES record last updated Jan 3, 2026
Key facts
- NPI
- 1124984166
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Case Management Agency 251B00000X
- License
- RN285050 (GA)
- Practice address
- 181 Lola St
Colbert, GA 30628-6644 - Phone
- (706) 296-1979
- Fax
- (706) 296-1979
- NPI assigned
- Jan 3, 2026
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN285050 | GA | MD | Case Management Agency |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Blue Lakes Care LLC | Case Management | Current |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Management Agency | 251B00000X | RN285050 | GA | Yes |
Addresses
Primary practice location
181 Lola St
Colbert, GA 30628-6644
Mailing address
181 Lola St
Colbert, GA 30628-6644
Phone (706) 296-1979
Other providers in Colbert, GA
- Karla Coco
- Colbert Pharmacy Inc 127 4TH St
- Robyn Cain Crouse
- Matthew Davis
- Nicole Ford
- Manuel Garcia-Gaona
- Evan Grovenstein
- Yvette Henderson
- Jordan Hoffman
- Alicia M Hopkins
All providers in Colbert, GA · Case Management Agency in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 3, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.