F&M Wellness LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

F&M WELLNESS LLC

Practice address

614 Mullins Colony Dr
Evans, GA 30809-0579

Phone

(706) 760-7272

Fax

(706) 760-7276

NPI assigned

Aug 18, 2023

Organization subpart

No

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

Authorized official

Name

Melissa Broske Jacome, FNP-C

Title

Nurse Practitioner

Phone

(706) 294-6485

Specialties & licenses 9

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Melissa Renee Broske, APRN

  • Family Nurse Practitioner
  • Evans, GA
  • NPI 1184190647
  NPD

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

{
    "created_epoch": "1692316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705622400000",
    "number": "1225812571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4313 SOUTHERN PINES DR",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308095147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "614 MULLINS COLONY DR",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308090579",
            "telephone_number": "706-760-7272",
            "fax_number": "706-760-7276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "F&M WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-18",
        "last_updated": "2024-01-19",
        "certification_date": "2024-01-19",
        "status": "A",
        "authorized_official_last_name": "JACOME",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_middle_name": "BROSKE",
        "authorized_official_title_or_position": "NURSE PRACTITIONER",
        "authorized_official_telephone_number": "706-294-6485",
        "authorized_official_credential": "FNP-C"
    },
    "taxonomies": [
        {
            "code": "133NN1002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nutritionist, Nutrition, Education",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207QB0002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Obesity Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2083B0002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Preventive Medicine, Obesity Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QI0500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Infusion Therapy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Evans Signature Dentistry LLC
• Evans Urgent Care
• Kelli Lane Evans, FNP-BC
• Extraordinary Homecare LLC
• Eyecare One Martinez LLC
• Family Physicians of Evans
• Jackleen Fan
• Edwin Alonzo Farnell IV, MD
• Jerrod Farrell
• Little Neal Felton Jr., PMHNP-BC

• Family Medicine Physician in Evans, GA
• Providers in Evans, GA by specialty
• Family Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2024; 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.