Individual provider Active NPI

Jessica Nicole Breaux, NP

  • Nurse Practitioner
  • Fayetteville, GA
National Provider Identifier
1205445426
Registry record updated Sep 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN-NP239680 Issued in GA
Practice address
1267 Highway 54 W Ste 2200
Fayetteville, GA 30214-2110
Phone
(770) 716-0051
NPI assigned
Jul 23, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN239680 GA
Nurse Practitioner 363L00000X APRN-NP239680 GA Primary

Addresses

Primary practice location

1267 Highway 54 W Ste 2200
Fayetteville, GA 30214-2110

Mailing address

195 Coweta Lake Rd
Newnan, GA 30265-1815
Phone (404) 226-4836

Other practice location 1

59 Hospital Rd
Newnan, GA 30263-1209
Phone (678) 423-4610

Other identifiers 1

IdentifierTypeStateIssuer
239680MedicaidGA

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
I20251119001856 GA Practitioner - Nurse Practitioner 9234620089 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Piedmont Cardiology of Atlanta, LLCGroup PAC ID 0345321691, 478 clinicians

Practice addresses (Care Compare)

20 Francis Way
Suite 201
Sharpsburg, GA 30277-3589
Phone (770) 254-6089

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN239680GAMDRegistered Nurse
APRN-NP239680GAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Piedmont Cardiology of Atlanta, LLC CurrentSince Sep 22, 2025 Accepting new patients

Locations

1412 Milstead Ave NE
Conyers, GA 30012
Phone (770) 918-3000

1267 Highway 54 W
Ste 2200
Fayetteville, GA 30214
Phone (470) 271-3415

795 Poplar Rd
Ste 400
Newnan, GA 30265
Phone (770) 254-6089

20 Francis Way
Ste 201
Sharpsburg, GA 30277
Phone (770) 254-6089

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 and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1595462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757980800000",
    "number": "1205445426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "195 COWETA LAKE RD",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302651815",
            "telephone_number": "404-226-4836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1267 HIGHWAY 54 W STE 2200",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302142110",
            "telephone_number": "770-716-0051"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "59 Hospital Rd",
            "address_purpose": "LOCATION",
            "city": "Newnan",
            "state": "GA",
            "postal_code": "302631209",
            "country_code": "US",
            "telephone_number": "678-423-4610",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BREAUX",
        "first_name": "JESSICA",
        "middle_name": "NICOLE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-23",
        "last_updated": "2025-09-16",
        "certification_date": "2025-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GA",
            "license": "RN239680",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "APRN-NP239680",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "239680",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, GA

Sources for this page

Verify at the official NPI Registry.