Individual provider Active NPI

Angela Marie Hinely, NP

  • Family Nurse Practitioner
  • Savannah, GA
National Provider Identifier
1023502903
Registry record updated Apr 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN230397 Issued in GA
Practice address
11909 McAuley Drive
Suite 100 A2
Savannah, GA 31419
Phone
(912) 354-8331
Fax
(912) 352-9782
NPI assigned
Jun 14, 2018
Last updated
Apr 24, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2020

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 RN230397 GA Primary

Addresses

Primary practice location

11909 McAuley Drive
Suite 100 A2
Savannah, GA 31419

Mailing address

836 E. 65TH Street
Suite 22
Savannah, GA 31405
Phone (912) 819-7878

Other identifiers 1

IdentifierTypeStateIssuer
003208596AMedicaidGA

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
I20180921001138 GA Practitioner - Nurse Practitioner 2961753421 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN230397GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St. Joseph's Vascular Group, LLC CurrentSince Aug 1, 2018 Accepting new patients

Locations

101 Saint Josephs Candler Dr
Ste 210
Pooler, GA 31322

11909 McAuley Dr
Ste A2
Savannah, GA 31419
Phone (912) 925-3767

5102 Paulsen St
Bldg 2
Savannah, GA 31405
Phone (912) 954-8331

836 E 65th St
Ste 22
Savannah, GA 31405
Phone (912) 819-7878

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1528934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587686400000",
    "number": "1023502903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "836 E. 65TH STREET",
            "address_2": "SUITE 22",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "31405",
            "telephone_number": "912-819-7878",
            "fax_number": "912-819-3320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11909 MCAULEY DRIVE",
            "address_2": "SUITE 100 A2",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "31419",
            "telephone_number": "912-354-8331",
            "fax_number": "912-352-9782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HINELY",
        "first_name": "ANGELA",
        "middle_name": "MARIE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-14",
        "last_updated": "2020-04-24",
        "certification_date": "2020-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN230397",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003208596A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Savannah, GA

Sources for this page

Verify at the official NPI Registry.