Jessica Caroline Mimbs, RN, MSN, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN239259 Issued in GA

Practice address

6120 Hickory Flat Hwy
Canton, GA 30115

Phone

(866) 389-2727

Fax

(401) 652-9787

NPI assigned

Aug 24, 2016

Last updated

Feb 4, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Jessica Caroline Brown Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Registered Nurse

State licenses

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H3359

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

{
    "created_epoch": "1471996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612396800000",
    "number": "1932654563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6120 HICKORY FLAT HWY",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "30115",
            "telephone_number": "407-247-6442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6120 HICKORY FLAT HWY",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "30115",
            "telephone_number": "866-389-2727",
            "fax_number": "401-652-9787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIMBS",
        "first_name": "JESSICA",
        "middle_name": "CAROLINE",
        "credential": "RN, MSN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-24",
        "last_updated": "2021-02-04",
        "certification_date": "2021-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN239259",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "GA",
            "license": "RN239259",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN239259",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GA NP LICENSE",
            "identifier": "RN239259",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Other",
            "affiliation": "N",
            "address_1": "6120 Hickory Flat Hwy",
            "city": "Canton",
            "state": "GA",
            "country_code": "US",
            "postal_code": "30115",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "BROWN",
            "middle_name": "CAROLINE",
            "credential": "RN, MSN, FNP-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Family Nurse Practitioner in Canton, GA
• Providers in Canton, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2021; 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.