Individual provider Active NPI

Jennifer Paulette Miles-Brown, PHD

  • Clinical Medical Laboratory
  • Union City, GA
National Provider Identifier
1285373852
Registry record updated Dec 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Practice address
6781 Londonderry Way Unit 4a
Union City, GA 30291-2094
Phone
(404) 465-1555
NPI assigned
Jun 1, 2022
Last updated
Dec 13, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 13, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Laboratory Technician 246RM2200X
Phlebotomy Technician 246RP1900X
Point of Service 305S00000X
Clinical Medical Laboratory 291U00000X Primary

Addresses

Primary practice location

6781 Londonderry Way Unit 4a
Union City, GA 30291-2094

Mailing address

109 Scarbrush CT
Stockbridge, GA 30281-1017
Phone (510) 932-3814

Other practice location 1

109 Scarbrush Ct
Stockbridge, GA 30281-1017
Phone (404) 465-1555

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Xpress Laboratory Services LLC Clinical Medical Laboratory CurrentSince Dec 17, 2023 Accepting new patients

Locations

6781 Londonderry Way
Unit 4A
Union City, GA 30291
Phone (404) 465-1555

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, 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": "1654041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702425600000",
    "number": "1285373852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 SCARBRUSH CT",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302811017",
            "telephone_number": "510-932-3814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6781 LONDONDERRY WAY UNIT 4A",
            "city": "UNION CITY",
            "state": "GA",
            "postal_code": "302912094",
            "telephone_number": "404-465-1555"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "109 Scarbrush Ct",
            "address_purpose": "LOCATION",
            "city": "Stockbridge",
            "state": "GA",
            "postal_code": "302811017",
            "country_code": "US",
            "telephone_number": "404-465-1555",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILES-BROWN",
        "first_name": "JENNIFER",
        "middle_name": "PAULETTE",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-01",
        "last_updated": "2023-12-13",
        "certification_date": "2023-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246RM2200X",
            "taxonomy_group": "",
            "desc": "Technician, Pathology, Medical Laboratory",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "246RP1900X",
            "taxonomy_group": "",
            "desc": "Technician, Pathology, Phlebotomy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Union City, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2023; 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.