Individual provider Active NPI

Kenzlee Dubberly

  • Registered Nurse
  • Jesup, GA
National Provider Identifier
1992626410
Registry record updated Jul 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
319257 Issued in GA
Practice address
240 Peachtree St
Jesup, GA 31545-0212
Phone
(912) 427-2043
NPI assigned
Jul 22, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 319257 GA Primary

Addresses

Primary practice location

240 Peachtree St
Jesup, GA 31545-0212

Mailing address

240 Peachtree St
Jesup, GA 31545-0212
Phone (912) 427-2043

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1784678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784678400000",
    "number": "1992626410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 PEACHTREE ST",
            "city": "JESUP",
            "state": "GA",
            "postal_code": "315450212",
            "telephone_number": "912-427-2043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 PEACHTREE ST",
            "city": "JESUP",
            "state": "GA",
            "postal_code": "315450212",
            "telephone_number": "912-427-2043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUBBERLY",
        "first_name": "KENZLEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-07-22",
        "last_updated": "2026-07-22",
        "certification_date": "2026-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GA",
            "license": "319257",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jesup, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2026; 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.