Individual provider Active NPI

Jennifer Simms, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Griffin, GA
National Provider Identifier
1437870284
Registry record updated Dec 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
301932 Issued in GA
Practice address
1435 N Expressway Ste 301
Griffin, GA 30223-9014
Phone
(770) 358-5252
NPI assigned
Sep 9, 2022
Last updated
Dec 30, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 301932 GA Primary
Registered Nurse 163W00000X 66256 WV
Registered Nurse 163W00000X 301932 GA

Addresses

Primary practice location

1435 N Expressway Ste 301
Griffin, GA 30223-9014

Mailing address

143D Hickman Fork Rd
Thomaston, GA 30286-2069

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
I20250117001450 GA Practitioner - Nurse Practitioner 8325577422 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1209 Greenbelt Dr
Griffin, GA 30224-4507
Phone (770) 358-5252

1459 Williamson Rd
Griffin, GA 30224-8428
Phone (770) 358-8250

463 B Ernest Biles Dr
Jackson, GA 30233-2229
Phone (770) 775-6645

715 Bradley Dr
Fayetteville, GA 30214-2030
Phone (770) 358-8622

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
301932GAMDRegistered Nurse
66256WVMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
McIntosh Trail Community Service Board CurrentSince Jan 6, 2025 Accepting new patients
McIntosh Trail Community Service Board CurrentSince Jan 6, 2025 Accepting new patients
McIntosh Trail Community Service Board Past Accepting new patients

Locations

1209 Greenbelt Dr
Griffin, GA 30224
Phone (770) 358-8250

1435 N Expressway
Ste 301
Griffin, GA 30223
Phone (678) 516-5179

Organizations & group practices 3

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": "1662681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735516800000",
    "number": "1437870284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "143D HICKMAN FORK RD",
            "city": "THOMASTON",
            "state": "GA",
            "postal_code": "302862069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1435 N EXPRESSWAY STE 301",
            "city": "GRIFFIN",
            "state": "GA",
            "postal_code": "302239014",
            "telephone_number": "770-358-5252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMMS",
        "first_name": "JENNIFER",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-09",
        "last_updated": "2024-12-30",
        "certification_date": "2024-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "GA",
            "license": "301932",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WV",
            "license": "66256",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GA",
            "license": "301932",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Griffin, GA

Sources for this page

Verify at the official NPI Registry.