Sarah Suzanne Ridgeway, APRN

Individual provider Active NPI Primary Care Nurse Practitioner · Folkston, GA

NPI 1245249176 · NPPES record last updated Dec 11, 2012

Key facts

NPI
1245249176
Entity type
Individual (NPI type 1)
Primary specialty
Primary Care Nurse Practitioner 363LP2300X
License
RN156030 NP-C (GA)
Practice address
2383 Third St
Folkston, GA 31537-8917
Phone
(912) 496-2697
Fax
(912) 496-1139
NPI assigned
Aug 7, 2006
Sex
Female
Sole proprietor
No

Organizations & group practices 1

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.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN156030 NP-CGAMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wings of Feathers Medical Clinic Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X RN156030 NP-C GA Yes

Addresses

Primary practice location

2383 Third St
Folkston, GA 31537-8917

Mailing address

2383 Third St
Folkston, GA 31537-8917
Phone (912) 496-2697

Other identifiers

IdentifierTypeStateIssuer
338490004CMedicaidGA

Other providers in Folkston, GA

All providers in Folkston, GA · Primary Care Nurse Practitioner in Georgia

Sources for this page

Verify at the official NPI Registry.