Individual provider Active NPI

Jessica L Hubbard, FNP-C

  • Family Nurse Practitioner
  • Dawsonville, GA
National Provider Identifier
1790305894
Registry record updated Oct 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN249359 Issued in GA
Practice address
378 Marketplace Pkwy
Dawsonville, GA 30534-7266
Phone
(678) 389-6509
NPI assigned
Apr 20, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 23, 2023

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 RN249359 GA Primary
Registered Nurse 163W00000X RN249359 GA

Addresses

Primary practice location

378 Marketplace Pkwy
Dawsonville, GA 30534-7266

Mailing address

4895 Post Rd
Cumming, GA 30040-4978

Other practice location 1

1219 Univeter Rd
Canton, GA 30115-8261
Phone (404) 452-2186

Other practice location 2

4895 Post Rd
Cumming, GA 30040-4978
Phone (866) 389-2626

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
I20220614001189 GA Practitioner - Nurse Practitioner 7517346059 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Monogram Health Professional Services PC Family CurrentSince Apr 18, 2025 Accepting new patients
Monogram Health Professional Services PC Family CurrentSince Apr 18, 2025 Accepting new patients
TLC of Georgia LLC Family CurrentSince Jul 18, 2022 Accepting new patients

Locations

3350 Riverwood Pkwy SE
Ste 1900
Atlanta, GA 30339
Phone (404) 277-2167

455 Nathan Dean Blvd
Dallas, GA 30132
Phone (770) 443-8776

378 Marketplace Pkwy
Dawsonville, GA 30534
Phone (470) 375-1995

3600 Dallas Hwy SW
Marietta, GA 30064
Phone (770) 420-9170

Interoperability endpoints

  • Direct secure messaging: jessica.hubbard.1@22854.direct.athenahealth.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1587340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698019200000",
    "number": "1790305894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4895 POST RD",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300404978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "378 MARKETPLACE PKWY",
            "city": "DAWSONVILLE",
            "state": "GA",
            "postal_code": "305347266",
            "telephone_number": "678-389-6509"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1219 Univeter Rd",
            "address_purpose": "LOCATION",
            "city": "Canton",
            "state": "GA",
            "postal_code": "301158261",
            "country_code": "US",
            "telephone_number": "404-452-2186",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4895 Post Rd",
            "address_purpose": "LOCATION",
            "city": "Cumming",
            "state": "GA",
            "postal_code": "300404978",
            "country_code": "US",
            "telephone_number": "866-389-2626",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HUBBARD",
        "first_name": "JESSICA",
        "middle_name": "L",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-20",
        "last_updated": "2023-10-23",
        "certification_date": "2023-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN249359",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GA",
            "license": "RN249359",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dawsonville, GA

Sources for this page

Verify at the official NPI Registry.