Brianna Nicole Jefferson

Primary specialty

Rehabilitation PractitionerTaxonomy code 225400000X

License

AT003789 Issued in GA

Practice address

3375 Spring Hill Pkwy SE Apt 1034
Smyrna, GA 30080-6837

Phone

(256) 663-9172

NPI assigned

Dec 16, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1608076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608076800000",
    "number": "1942896774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8259 WICKER AVE",
            "city": "SAINT JOHN",
            "state": "IN",
            "postal_code": "463738878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3375 SPRING HILL PKWY SE APT 1034",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300806837",
            "telephone_number": "256-663-9172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEFFERSON",
        "first_name": "BRIANNA",
        "middle_name": "NICOLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-16",
        "last_updated": "2020-12-16",
        "certification_date": "2020-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": "GA",
            "license": "AT003789",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4046518681",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "MVISION",
            "affiliation": "N",
            "endpointDescription": "Defend against modern threats",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3375 Spring Hill Pkwy SE Apt 1034",
            "city": "Smyrna",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300806837",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Alessia Maria Jankowski, PHARMD
• Richard C Jarrell, MD
• Jarrett L. Manning, DDS, PC
• Jason a. King, PH.D., LLC
• Hatinawedu Tina Jaya, OTR/L,MPH,CHT
• Shellina R Jenkins, LPC
• Jennings W Bristol DDS PC
• Charay Jennings-Dover, M.D., PH.D.
• Courtney D Jennings, PHARMD
• Jenny Van Overbeke Brooks, PH.D., P.C.

• Rehabilitation Practitioner in Smyrna, GA
• Providers in Smyrna, GA by specialty
• Rehabilitation Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2020; 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.