Jessica R Coburn, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN330929 Issued in GA

Practice address

100 Market Place Blvd Ste 301
Cartersville, GA 30121-8717

Phone

(678) 290-4817

NPI assigned

Oct 6, 2019

Last updated

Oct 9, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in SC

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

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Hospice Care of the Lowcountry, IncGroup PAC ID 3779520655, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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.

• Hospice Care of the Lowcountry, Inc.

  dba Lowcountry Palliative Care

  • Acute Care Nurse Practitioner
  • Bluffton, SC
  • NPI 1811563513
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1570320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728432000000",
    "number": "1245871763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1452 CHESTER HARRIS DR N",
            "city": "DALLAS",
            "state": "GA",
            "postal_code": "301320368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MARKET PLACE BLVD STE 301",
            "city": "CARTERSVILLE",
            "state": "GA",
            "postal_code": "301218717",
            "telephone_number": "678-290-4817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COBURN",
        "first_name": "JESSICA",
        "middle_name": "R",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-06",
        "last_updated": "2024-10-09",
        "certification_date": "2024-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "23255",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN330929",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PG1120",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kathryn Head Claytor, FNP-C
• Paul Clements, PH.D.
• Tinsley Choate Cline, DMD
• William James Cline, DMD
• Crystal Elaine Clough, FNP
• Jeannette Chua Cocabo, MD
• Renee' S. Cochran, NP
• Sara Beth Coker, NP-C
• Mitzi Collins
• Talley Collins, LPN

• Family Nurse Practitioner in Cartersville, GA
• Providers in Cartersville, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.