Individual provider Active NPI

Stephanie E Pinard, FNP

  • Family Nurse Practitioner
  • Statesboro, GA
National Provider Identifier
1063062511
Registry record updated Dec 31, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN154660 Issued in GA
Practice address
5 Grady Johnson Rd
Statesboro, GA 30458-6026
Phone
(912) 489-6246
NPI assigned
Sep 17, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 31, 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 RN154660 GA Primary

Addresses

Primary practice location

5 Grady Johnson Rd
Statesboro, GA 30458-6026

Mailing address

5 Grady Johnson Rd
Statesboro, GA 30458-6026
Phone (912) 489-6246

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
I20200615003020 GA Practitioner - Nurse Practitioner 4082036314 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Statesboro Cardiology, PCGroup PAC ID 5294704508, 8 clinicians

Practice addresses (Care Compare)

5 Grady Johnson Rd
Statesboro, GA 30458-6026
Phone (912) 489-6246

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Statesboro Cardiology, PC CurrentSince Sep 30, 2019 Accepting new patients
Genesis Vascular of Pooler, LLC PastSince Sep 25, 2019 Accepting new patients

Locations

380 Sconyers St
Metter, GA 30439
Phone (912) 685-1215

1601 Fair Rd
Ste 5010
Statesboro, GA 30458

5 Grady Johnson Rd
Statesboro, GA 30458
Phone (912) 489-6246

1499 Fair Rd
Statesboro, GA 30458
Phone (912) 486-1000

411 W 4th St
Waynesboro, GA 30830
Phone (706) 437-2690

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1568678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609372800000",
    "number": "1063062511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 GRADY JOHNSON RD",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304586026",
            "telephone_number": "912-489-6246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 GRADY JOHNSON RD",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304586026",
            "telephone_number": "912-489-6246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PINARD",
        "first_name": "STEPHANIE",
        "middle_name": "E",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-17",
        "last_updated": "2020-12-31",
        "certification_date": "2020-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN154660",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Statesboro, GA

Sources for this page

Verify at the official NPI Registry.