Individual provider Active NPI

Jennifer Ann Stevick, NP-C

  • Family Nurse Practitioner
  • Valdosta, GA
National Provider Identifier
1265700595
Registry record updated Apr 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN115879 Issued in GA
Practice address
2501 N. Patterson Street
Valdosta, GA 31602-1735
Phone
(229) 259-4600
Fax
(229) 259-4633
NPI assigned
Dec 1, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2015

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 RN115879 GA Primary

Addresses

Primary practice location

2501 N. Patterson Street
Valdosta, GA 31602-1735

Mailing address

PO Box 0070
Valdosta, GA 31603-0070
Phone (229) 259-4600

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
I20120328000822 GA Practitioner - Nurse Practitioner 6305006362 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
South Georgia Medical Center IncGroup PAC ID 1052764677, 58 clinicians

Practice addresses (Care Compare)

2501 N Patterson St
Valdosta, GA 31602-1735
Phone (229) 259-4291

Hospital & facility affiliations

  • SGMC Health Hospital, Valdosta, GA, CCN 110122
  • SGMC Health Lanier Hospital, Lakeland, GA, CCN 111326
  • SGMC Berrien Campus Hospital, Nashville, GA, CCN 110234

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN115879GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
South Georgia Medical Center Inc CurrentSince Jun 1, 2024 Accepting new patients
Hospital Authority of Valdosta and Lowndes County, Georgia CurrentSince Dec 9, 2014 Accepting new patients
South Georgia Medical Center Inc CurrentSince Jun 1, 2024 Accepting new patients
Hospital Authority of Valdosta and Lowndes County Georgia Current Accepting new patients
Hospital Authority of Valdosta and Lowndes County Georgia Current Accepting new patients
Hospital Authority of Valdosta and Lowndes County, Georgia CurrentSince Dec 9, 2014 Accepting new patients
Hospital Authority of Valdosta and Lowndes County Georgia Past Accepting new patients

Locations

2501 N Patterson St
Valdosta, GA 31602
Phone (229) 259-4139

2412 N Oak St
Valdosta, GA 31602
Phone (229) 244-1400

Interoperability endpoints

  • Direct secure messaging: jstevick7126@sgmc.gadirect.net

Organizations & group practices 7

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1322697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428364800000",
    "number": "1265700595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 0070",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316030070",
            "telephone_number": "229-259-4600",
            "fax_number": "229-259-4633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 N. PATTERSON STREET",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316021735",
            "telephone_number": "229-259-4600",
            "fax_number": "229-259-4633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEVICK",
        "first_name": "JENNIFER",
        "middle_name": "ANN",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-12-01",
        "last_updated": "2015-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN115879",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valdosta, GA

Sources for this page

Verify at the official NPI Registry.