Individual provider Active NPI

William Monroe Rouse Jr., APRN-BC

  • Acute Care Nurse Practitioner
  • Waycross, GA
National Provider Identifier
1124265426
Registry record updated Feb 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
RN140401 Issued in GA
Practice address
1900 Tebeau St
Waycross, GA 31501-6357
Phone
(912) 283-3030
NPI assigned
Jan 8, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X RN140401 GA Primary

Addresses

Primary practice location

1900 Tebeau St
Waycross, GA 31501-6357

Mailing address

3096 Warrior Rd
Waycross, GA 31503-8906
Phone (912) 550-9733

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
I20091222000515 GA Practitioner - Nurse Practitioner 7810037835 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1900 Tebeau St
Waycross, GA 31501-6357
Phone (912) 283-3030

501 Redmond Rd NW
Rome, GA 30165-1415
Phone (706) 291-0291

Hospital & facility affiliations

  • Memorial Satilla Health Hospital, Waycross, GA, CCN 110003

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Regional Laboratories Pathology Services, LLC Current Accepting new patients
Mayo Clinic Health System in Waycross, Inc. CurrentSince Jan 1, 2015 Accepting new patients
Hospital Physician Services - Southeast Professional Corporation CurrentSince Jul 31, 2019 Accepting new patients

Locations

501 Redmond Rd NW
Rome, GA 30165
Phone (706) 291-0291

1900 Tebeau St
Waycross, GA 31501
Phone (912) 283-3030

Organizations & group practices 3

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": "1231372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423094400000",
    "number": "1124265426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3096 WARRIOR RD",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "315038906",
            "telephone_number": "912-550-9733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 TEBEAU ST",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "315016357",
            "telephone_number": "912-283-3030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROUSE",
        "first_name": "WILLIAM",
        "middle_name": "MONROE",
        "name_suffix": "Jr.",
        "credential": "APRN-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-01-08",
        "last_updated": "2015-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "GA",
            "license": "RN140401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waycross, GA

Sources for this page

Verify at the official NPI Registry.