Individual provider Active NPI

Jessica Davis Gooden

  • Home Health Registered Nurse
  • Conyers, GA
National Provider Identifier
1619836038
Registry record updated Jan 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health Registered NurseTaxonomy code 163WH0200X
License
RN247090 Issued in GA
Practice address
2055 Gees Mill Rd NE
Conyers, GA 30013-1362
Phone
(470) 249-1083
NPI assigned
Jan 21, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Registered Nurse 163WH0200X RN247090 GA Primary

Addresses

Primary practice location

2055 Gees Mill Rd NE
Conyers, GA 30013-1362

Mailing address

3915 Peace Valley Dr
Atlanta, GA 30349-1509
Phone (540) 270-7161

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

State licenses

LicenseStateTypeSpecialty
RN247090GAMDHome Health Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1768953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768953600000",
    "number": "1619836038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3915 PEACE VALLEY DR",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303491509",
            "telephone_number": "540-270-7161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2055 GEES MILL RD NE",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300131362",
            "telephone_number": "470-249-1083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS GOODEN",
        "first_name": "JESSICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-01-21",
        "last_updated": "2026-01-21",
        "certification_date": "2026-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "GA",
            "license": "RN247090",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conyers, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2026; 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.