Individual provider Active NPI

Jimmy Howell, NP-C

  • Family Nurse Practitioner
  • Fitzgerald, GA
National Provider Identifier
1346713203
Registry record updated Jan 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN210349 Issued in GA
Practice address
116 Benjamin H Hill Dr SW Ste 12
Fitzgerald, GA 31750-9511
Phone
(229) 424-7263
Fax
(229) 423-3601
NPI assigned
Jan 3, 2019
Last updated
Jan 12, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN210349 GA Primary
Registered Nurse 163W00000X RN210349 GA

Addresses

Primary practice location

116 Benjamin H Hill Dr SW Ste 12
Fitzgerald, GA 31750-9511

Mailing address

104 Lakeview Cir
Fitzgerald, GA 31750-6505
Phone (229) 425-9055

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
I20190308000911 GA Practitioner - Nurse Practitioner 9739428772

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN210349GAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
DMC Physician Group LLC Past Accepting new patients
DMC Physician Group LLC Past Accepting new patients

Organizations & group practices 2

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": "1546473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547251200000",
    "number": "1346713203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 LAKEVIEW CIR",
            "city": "FITZGERALD",
            "state": "GA",
            "postal_code": "317506505",
            "telephone_number": "229-425-9055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 BENJAMIN H HILL DR SW STE 12",
            "city": "FITZGERALD",
            "state": "GA",
            "postal_code": "317509511",
            "telephone_number": "229-424-7263",
            "fax_number": "229-423-3601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOWELL",
        "first_name": "JIMMY",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-01-03",
        "last_updated": "2019-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN210349",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GA",
            "license": "RN210349",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fitzgerald, GA

Sources for this page

Verify at the official NPI Registry.