Individual provider Active NPI

Regina Ann Stone, FNP-C

  • Family Nurse Practitioner
  • Douglas, GA
National Provider Identifier
1154862894
Registry record updated Mar 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN113482 Issued in GA
Practice address
1003 Shirley Ave
Douglas, GA 31533-2123
Phone
(912) 389-4586
Fax
(912) 389-4590
NPI assigned
Mar 14, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 14, 2017

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 RN113482 GA Primary

Addresses

Primary practice location

1003 Shirley Ave
Douglas, GA 31533-2123

Mailing address

1003 Shirley Ave
Douglas, GA 31533-2123
Phone (912) 389-4586

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
I20180529002855 GA Practitioner - Nurse Practitioner 2567727209 Reassigns benefits to 4 organizations
Practice locations: Douglas, GA; Lyons, GA; Statesboro, GA

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
May accept Medicare assignment
Group practices
Bulloch County Board of HealthGroup PAC ID 5193710481, 4 clinicians
Coffee County Board of HealthGroup PAC ID 7416944087, 3 clinicians
Toombs County Board of HealthGroup PAC ID 4183612732, 3 clinicians

Practice addresses (Care Compare)

3 W Altman St
Statesboro, GA 30458-5212
Phone (912) 764-2402

310 Bryan St W
Douglas, GA 31533-4730
Phone (912) 389-4204

714 NW Broad St
Lyons, GA 30436-5648
Phone (912) 526-8108

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN113482GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Coffee County Board of Health Current Accepting new patients
Toombs County Wellness Center CurrentSince Jun 23, 2018 Accepting new patients
Toombs County Board of Health CurrentSince Jun 23, 2018 Accepting new patients
Bulloch County Board of Health CurrentSince Jun 22, 2018 Accepting new patients
Coffee County Board of Health CurrentSince Jun 23, 2018 Accepting new patients
Ware County Board of Health CurrentSince Dec 2, 2022 Accepting new patients
Bulloch County Board of Health CurrentSince Jun 22, 2018 Accepting new patients
Candler County Board of Health Past Accepting new patients

Locations

310 Bryan St W
Douglas, GA 31533
Phone (912) 389-4204

1003 Shirley Ave
Douglas, GA 31533
Phone (912) 389-4204

714 NW Broad St
Lyons, GA 30436
Phone (912) 526-8108

3 W Altman St
Statesboro, GA 30458
Phone (912) 764-2402

1102 Plant Ave
Waycross, GA 31501
Phone (912) 285-6002

1101 Church St
Waycross, GA 31501
Phone (912) 285-6010

Organizations & group practices 8

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": "1489449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489449600000",
    "number": "1154862894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1003 SHIRLEY AVE",
            "city": "DOUGLAS",
            "state": "GA",
            "postal_code": "315332123",
            "telephone_number": "912-389-4586",
            "fax_number": "912-389-4590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1003 SHIRLEY AVE",
            "city": "DOUGLAS",
            "state": "GA",
            "postal_code": "315332123",
            "telephone_number": "912-389-4586",
            "fax_number": "912-389-4590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STONE",
        "first_name": "REGINA",
        "middle_name": "ANN",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-14",
        "last_updated": "2017-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN113482",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Douglas, GA

Sources for this page

Verify at the official NPI Registry.