Individual provider Active NPI

Jacqueline Davon Brown, NP-C

  • Family Nurse Practitioner
  • Gastonia, NC
National Provider Identifier
1639721269
Registry record updated Feb 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5012406 Issued in NC
Practice address
1337 E Garrison Blvd
Gastonia, NC 28054-5127
Phone
(704) 865-3848
Fax
(704) 854-3086
NPI assigned
Jul 13, 2019
Last updated
Feb 2, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2026

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 29365 SC
Nurse Practitioner 363L00000X 173999 NC
Family Nurse Practitioner 363LF0000X 5012406 NC Primary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 29365 SC
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 5012406 NC

Addresses

Primary practice location

1337 E Garrison Blvd
Gastonia, NC 28054-5127

Mailing address

PO Box 744786
Atlanta, GA 30374-4786
Phone (704) 834-2450

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, SC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20220901001941 NC Practitioner - Nurse Practitioner 5294119707 Reassigns benefits to 5 organizations
I20241205000574 SC Practitioner - Nurse Practitioner 5294119707

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
173999NCMDNurse Practitioner
5012406NCMDPsychiatric/Mental Health Nurse Practitioner
29365SCMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Forsyth Memorial Hospital, Inc. Current Accepting new patients
Forsyth Memorial Hospital, Inc. CurrentSince Aug 2, 2024 Accepting new patients
Caromont Medical Group Inc Current Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Health Medical Group, LLC CurrentSince Aug 2, 2024 Accepting new patients
NMG Health Services LLC CurrentSince Aug 2, 2024 Accepting new patients
Novant Health Medical Group, LLC CurrentSince Aug 2, 2024 Accepting new patients
Caromont Medical Group Inc CurrentSince Sep 1, 2022 Accepting new patients
Novant Health Medical Group Coastal Region, LLC Current Accepting new patients
Signify Health Medical Associates, PLLC Nurse Practitioner CurrentSince May 8, 2023 Accepting new patients
Lifesource of North Carolina Nurse Practitioner CurrentSince Nov 4, 2024 Accepting new patients
Novant Health Medical Group Coastal Region, LLC CurrentSince Aug 2, 2024 Accepting new patients
Forsyth Memorial Hospital, Inc. CurrentSince Aug 2, 2024 Accepting new patients
Caromont Medical Group Inc CurrentSince Sep 1, 2022 Accepting new patients
Novant Health Medical Group, LLC Past Accepting new patients

Locations

1900 Randolph Rd
Ste 800
Charlotte, NC 28207
Phone (704) 941-4171

200 Hawthorne Ln
Charlotte, NC 28204
Phone (704) 377-2424

6301 Stadium Dr
Clemmons, NC 27012
Phone (336) 766-6473

1337 E Garrison Blvd
Gastonia, NC 28054
Phone (704) 671-5313

2525 Court Dr
Gastonia, NC 28054
Phone (704) 834-2662

13815 Professional Center Dr
Ste 100
Huntersville, NC 28078
Phone (704) 316-2050

291 Broad St
Kernersville, NC 27284
Phone (336) 993-8181

555 Fayetteville St
Raleigh, NC 27601
Phone (682) 268-1011

5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441

800 Jefferson St
Ste 112
Whiteville, NC 28472
Phone (910) 642-8164

2131 S 17th St
Wilmington, NC 28401
Phone (910) 342-3000

3205 Randall Pkwy
Ste 105
Wilmington, NC 28403
Phone (910) 338-2880

175 Kimel Park Dr
Ste 100
Winston Salem, NC 27103
Phone (336) 277-1811

2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Interoperability endpoints

  • Direct secure messaging: jbrown45480@direct.novanthealth.org

Organizations & group practices 15

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.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1562976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769990400000",
    "number": "1639721269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 744786",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303744786",
            "telephone_number": "704-834-2450",
            "fax_number": "704-671-5331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1337 E GARRISON BLVD",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280545127",
            "telephone_number": "704-865-3848",
            "fax_number": "704-854-3086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "JACQUELINE",
        "middle_name": "DAVON",
        "name_prefix": "Ms.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-13",
        "last_updated": "2026-02-02",
        "certification_date": "2026-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "SC",
            "license": "29365",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "173999",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5012406",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "SC",
            "license": "29365",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NC",
            "license": "5012406",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gastonia, NC

Sources for this page

Verify at the official NPI Registry.