Golden Isles Healthcare,LLC
Organization Active NPI Family Nurse Practitioner · MC Rae, GA
NPI 1164075347 · NPPES record last updated Jul 17, 2019
Key facts
- NPI
- 1164075347
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- Legal business name
- GOLDEN ISLES HEALTHCARE,LLC
- Practice address
- 144 E Oak St
MC Rae, GA 31055-4338 - Phone
- (229) 868-7342
- Fax
- (229) 868-4344
- NPI assigned
- Jul 17, 2019
- Organization subpart
- No
Authorized official
- Name
- Valarie I Webb, NP-C
- Title
- Nurse Practioner/ Owner
- Phone
- (229) 868-7342
Practitioners 5
-
Janet Boone, NP
-
Valarie Irene Webb, N.P.-C
-
John W Souza, MD
-
Edward F Stringer IV, M.D.
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 11D2172258 | Golden Isles Healthcare, LLC | Compliance | Oct 26, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20191010001533 | GA | Part B Supplier - Clinic/Group Practice | 3173854866 |
Receives reassigned benefits from 3 practitioners Practice locations: MC Rae, GA |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner |
363LF0000X | Yes |
Addresses
Primary practice location
144 E Oak St
MC Rae, GA 31055-4338
Mailing address
144 E Oak St
MC Rae, GA 31055-4338
Phone (229) 868-7342
Other providers in MC Rae, GA
- Kelly Hamilton Deloach
- Casey Dix
- Megan Deanna Dowdy
- Dr. Griffin E. Mizell D.D.S
- Clayton Kyle Ellis
- Rebecca Knowles Greene
- Habigaile Cribe, MD LLC
- Angela J Hardy
- Renee Hatcher
- Healthcare Systems of Georgia LLC
All providers in MC Rae, GA · Family Nurse Practitioner in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 17, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.