Healthcare Provider Details

I. General information

NPI: 1679271357
Provider Name (Legal Business Name): JC HEALTH GROUP PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/21/2023
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6500 WOODLAKE VILLAGE CIR
MIDLOTHIAN VA
23112-2200
US

IV. Provider business mailing address

5401 SWIFT FOX PL
MOSELEY VA
23120-2368
US

V. Phone/Fax

Practice location:
  • Phone: 571-523-5479
  • Fax: 804-374-8889
Mailing address:
  • Phone: 804-274-0262
  • Fax: 804-374-8889

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: JESSY A NWUBA
Title or Position: OWNER
Credential: NURSE PRACTITIONER
Phone: 571-523-5479