Individual provider Active NPI

Tonia Rana Salazar

  • Family Nurse Practitioner
  • Vidalia, GA
National Provider Identifier
1184341638
Registry record updated Oct 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN268369 Issued in GA
Practice address
1181 CV Mosley Blvd
Vidalia, GA 30474-8202
Phone
(912) 245-4335
NPI assigned
Oct 25, 2022
Last updated
Oct 25, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2022

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 RN268369 GA Primary

Addresses

Primary practice location

1181 CV Mosley Blvd
Vidalia, GA 30474-8202

Mailing address

1181 CV Mosley Blvd
Vidalia, GA 30474-8202
Phone (912) 245-4335

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
I20230821002535 GA Practitioner - Nurse Practitioner 1052773157 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN268369GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
East Georgia Healthcare Center, Inc. Current Accepting new patients
East Georgia Healthcare Center, Inc. CurrentSince Jul 16, 2023 Accepting new patients
East Georgia Healthcare Center, Inc. CurrentSince Jul 16, 2023 Accepting new patients

Locations

117 Memorial Dr
Reidsville, GA 30453
Phone (912) 557-3300

215 N Coleman St
Swainsboro, GA 30401
Phone (478) 237-6262

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, 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": "1666656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666656000000",
    "number": "1184341638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1181 CV MOSLEY BLVD",
            "city": "VIDALIA",
            "state": "GA",
            "postal_code": "304748202",
            "telephone_number": "912-245-4335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1181 CV MOSLEY BLVD",
            "city": "VIDALIA",
            "state": "GA",
            "postal_code": "304748202",
            "telephone_number": "912-245-4335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALAZAR",
        "first_name": "TONIA",
        "middle_name": "RANA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-25",
        "last_updated": "2022-10-25",
        "certification_date": "2022-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN268369",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vidalia, GA

Sources for this page

Verify at the official NPI Registry.