Individual provider Active NPI

Skylar Nelson, NP

  • Family Nurse Practitioner
  • Macon, GA
National Provider Identifier
1003468240
Registry record updated Jul 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN240180 Issued in GA
Practice address
330 Hospital Dr Ste 200
Macon, GA 31217-8034
Phone
(478) 745-1191
NPI assigned
Jul 9, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN240180 GA Primary

Addresses

Primary practice location

330 Hospital Dr Ste 200
Macon, GA 31217-8034

Mailing address

330 Hospital Dr Ste 200
Macon, GA 31217-8034
Phone (478) 745-1191

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
I20190827002460 GA Practitioner - Nurse Practitioner 0446588586 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN240180GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Internal Medicine Associates, P.C. CurrentSince Jul 1, 2019 Accepting new patients

Locations

330 Hospital Dr
Ste 200
Macon, GA 31217
Phone (478) 745-1191

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EBBAAA
  • FHIR API: https://fhir4.healow.com/fhir/r4/CJBGAA/Endpoint/CJBGAA
  • FHIR API: https://fhir4.healow.com/fhir/r4/IDFHBD

Organizations & group practices 1

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": "1562630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562630400000",
    "number": "1003468240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 HOSPITAL DR STE 200",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312178034",
            "telephone_number": "478-745-1191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 HOSPITAL DR STE 200",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312178034",
            "telephone_number": "478-745-1191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "SKYLAR",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-09",
        "last_updated": "2019-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN240180",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Macon, GA

Sources for this page

Verify at the official NPI Registry.