Individual provider Active NPI

Janice Paulino Ramirez, FNP-C

  • Family Nurse Practitioner
  • Saint Marys, GA
National Provider Identifier
1053660738
Registry record updated Jan 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
183690 Issued in GA
Practice address
2040 Dan Proctor Drive, Suite 170
St Marys, GA 31558
Phone
(912) 882-6767
NPI assigned
Sep 10, 2012
Last updated
Jan 9, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2014

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 183690 GA Primary

Addresses

Primary practice location

2040 Dan Proctor Drive, Suite 170
St Marys, GA 31558

Mailing address

2060 Dan Proctor Dr Ste 2100
Saint Marys, GA 31558-3895
Phone (912) 882-6767

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20121011000337 GA Practitioner - Nurse Practitioner 1658520416 Reassigns benefits to 2 organizations
I20180112000598 FL Practitioner - Nurse Practitioner 1658520416 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
98
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
183690GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Physicians Inc CurrentSince Nov 30, 2017 Accepting new patients
Cooperative Healthcare Services Inc CurrentSince Sep 2, 2012 Accepting new patients
Emergency Physicians Inc CurrentSince Sep 15, 2016 Accepting new patients
Advanced Pediatric Specialists LLC Past Accepting new patients

Locations

1250 S 18th St
Ste 202
Fernandina Beach, FL 32034
Phone (904) 202-2000

1747 Baptist Clay Dr
Ste 250
Fleming Isle, FL 32003
Phone (904) 516-1000

820 Prudential Dr
Ste 713
Jacksonville, FL 32207
Phone (800) 936-5996

2415 Parkwood Dr
Brunswick, GA 31520
Phone (912) 466-4079

2040 Dan Proctor Dr
Ste 170
Saint Marys, GA 31558
Phone (912) 882-6767

2060 Dan Proctor Dr
Ste 2100
Saint Marys, GA 31558
Phone (912) 264-1520

Organizations & group practices 4

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": "1347235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389225600000",
    "number": "1053660738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2060 DAN PROCTOR DR STE 2100",
            "city": "SAINT MARYS",
            "state": "GA",
            "postal_code": "315583895",
            "telephone_number": "912-882-6767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2040 DAN PROCTOR DRIVE, SUITE 170",
            "city": "ST MARYS",
            "state": "GA",
            "postal_code": "31558",
            "telephone_number": "912-882-6767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAMIREZ",
        "first_name": "JANICE",
        "middle_name": "PAULINO",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-10",
        "last_updated": "2014-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "183690",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Marys, GA

Sources for this page

Verify at the official NPI Registry.