Individual provider Active NPI

Amanda Gail Jones

  • Family Nurse Practitioner
  • Statesboro, GA
National Provider Identifier
1194494039
Registry record updated Jun 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN273117 Issued in GA
Practice address
4451 Country Club Rd
Statesboro, GA 30458-9233
Phone
(912) 764-2273
NPI assigned
Sep 13, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 28, 2024

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 RN273117 GA Primary

Addresses

Primary practice location

4451 Country Club Rd
Statesboro, GA 30458-9233

Mailing address

15 Glenmore Dr
Guyton, GA 31312-7526
Phone (205) 495-6269

Other practice location 1

107 Canal St
Pooler, GA 31322-4016
Phone (912) 450-1949

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
I20211027000443 GA Practitioner - Nurse Practitioner 4486042322 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Josephs Candler Urgent Care Centers LLCGroup PAC ID 5092058016, 38 clinicians

Practice addresses (Care Compare)

107 Canal St
Pooler, GA 31322-4016
Phone (912) 450-1945

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St Josephs Candler Urgent Care Centers LLC CurrentSince Jun 28, 2024 Accepting new patients
St Josephs Candler Urgent Care Centers LLC CurrentSince Jun 28, 2024 Accepting new patients
East Georgia Urgent Care PastSince Oct 15, 2021 Accepting new patients

Locations

64 Oracal Pkwy
Bldg 1
Ellabell, GA 31308
Phone (912) 214-7920

780 E Oglethorpe Hwy
Hinesville, GA 31313
Phone (912) 332-7262

101 Saint Josephs Candler Dr
Ste 100
Pooler, GA 31322
Phone (912) 450-1945

107 Canal St
Pooler, GA 31322
Phone (912) 450-1945

13314 Highway 144
Ste C
Richmond Hill, GA 31324
Phone (912) 910-2010

5621 Highway 21 S
Rincon, GA 31326
Phone (912) 295-5860

361 Commercial Dr
Savannah, GA 31406
Phone (912) 355-6221

1096 Bermuda Run
Statesboro, GA 30458
Phone (912) 871-5150

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.

NPI Registry JSON

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

{
    "created_epoch": "1631491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719532800000",
    "number": "1194494039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 GLENMORE DR",
            "city": "GUYTON",
            "state": "GA",
            "postal_code": "313127526",
            "telephone_number": "205-495-6269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4451 COUNTRY CLUB RD",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304589233",
            "telephone_number": "912-764-2273"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "107 Canal St",
            "address_purpose": "LOCATION",
            "city": "Pooler",
            "state": "GA",
            "postal_code": "313224016",
            "country_code": "US",
            "telephone_number": "912-450-1949",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JONES",
        "first_name": "AMANDA",
        "middle_name": "GAIL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-13",
        "last_updated": "2024-06-28",
        "certification_date": "2024-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN273117",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Statesboro, GA

Sources for this page

Verify at the official NPI Registry.