Individual provider Active NPI

Jessica Brumfield Mitchum, DO

  • Family Medicine Physician
  • Moultrie, GA
National Provider Identifier
1629510912
Registry record updated Sep 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
83656 Issued in GA
Practice address
3131 S Main St
Moultrie, GA 31768-6925
Phone
(229) 502-9769
Fax
(229) 985-3751
NPI assigned
Nov 17, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 83656 GA Primary

Addresses

Primary practice location

3131 S Main St
Moultrie, GA 31768-6925

Mailing address

PO Box 2876
Moultrie, GA 31776-2876
Phone (229) 502-9769

Other names 1

  • Jessica Nicole Brumfield Former name

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190828003008 GA Practitioner - Family Practice 1658609680 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Philadelphia College of Osteopathic Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Colquitt Regional Medical CenterGroup PAC ID 6204821796, 20 clinicians

Practice addresses (Care Compare)

3131 S Main St
Moultrie, GA 31768-6925
Phone (229) 985-3420

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Colquitt Regional Medical Center Current Accepting new patients
Colquitt Regional Medical Center CurrentSince Jul 29, 2019 Accepting new patients
Colquitt Regional Medical Center Family Medicine CurrentSince Jul 29, 2019 Accepting new patients
Colquitt Regional Medical Center Family Medicine Past Accepting new patients

Locations

1 Magnolia Ct
Moultrie, GA 31768
Phone (229) 502-9753

3131 Thomasville Hwy
Moultrie, GA 31768
Phone (229) 502-9769

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1479340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756944000000",
    "number": "1629510912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2876",
            "city": "MOULTRIE",
            "state": "GA",
            "postal_code": "317762876",
            "telephone_number": "229-502-9769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3131 S MAIN ST",
            "city": "MOULTRIE",
            "state": "GA",
            "postal_code": "317686925",
            "telephone_number": "229-502-9769",
            "fax_number": "229-985-3751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHUM",
        "first_name": "JESSICA",
        "middle_name": "BRUMFIELD",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-17",
        "last_updated": "2025-09-04",
        "certification_date": "2025-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "83656",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "BRUMFIELD",
            "middle_name": "NICOLE",
            "credential": "DO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Moultrie, GA

Sources for this page

Verify at the official NPI Registry.