Individual provider Active NPI

Regina Mercer Ward, MSN, FNP-C

  • Family Nurse Practitioner
  • Moultrie, GA
National Provider Identifier
1194208751
Registry record updated Apr 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN197952 Issued in GA
Practice address
1724 Villa Dr SW
Moultrie, GA 31768
Phone
(229) 921-1754
NPI assigned
Sep 10, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 29, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN197952 GA Primary
Family Nurse Practitioner 363LF0000X F08180511 GA

Addresses

Primary practice location

1724 Villa Dr SW
Moultrie, GA 31768

Mailing address

1724 Villa Dr SW
Moultrie, GA 31768
Phone (229) 921-1754

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
F08180511GAMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1536537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556496000000",
    "number": "1194208751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1724 VILLA DR SW",
            "city": "MOULTRIE",
            "state": "GA",
            "postal_code": "31768",
            "telephone_number": "229-921-1754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1724 VILLA DR SW",
            "city": "MOULTRIE",
            "state": "GA",
            "postal_code": "31768",
            "telephone_number": "229-921-1754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARD",
        "first_name": "REGINA",
        "middle_name": "MERCER",
        "credential": "MSN, FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-09-10",
        "last_updated": "2019-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN197952",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "F08180511",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moultrie, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.