Individual provider Active NPI

Jennifer Ann Hales, NP-C #F05200177

  • Nurse Practitioner
  • Savannah, GA
National Provider Identifier
1285241265
Registry record updated Sep 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN196020 Issued in GA
Practice address
11909 McAuley Dr Ste 1002a
Savannah, GA 31419-1793
Phone
(912) 354-8331
NPI assigned
Sep 24, 2020
Last updated
Sep 1, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 1, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN196020 GA Primary
Vascular Surgery Physician 2086S0129X RN196020 GA

Addresses

Primary practice location

11909 McAuley Dr Ste 1002a
Savannah, GA 31419-1793

Mailing address

836 E 65TH St Ste 22
Savannah, GA 31405-4493
Phone (912) 414-6034

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
I20201216000909 GA Practitioner - Nurse Practitioner 7618389602 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St. Joseph's Vascular Group, LLCGroup PAC ID 6305163650, 6 clinicians

Practice addresses (Care Compare)

11909 McAuley Dr
Suite 100A2
Savannah, GA 31419-1793
Phone (912) 354-8331

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN196020GAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St. Joseph's Vascular Group, LLC Single Specialty CurrentSince Dec 1, 2020 Accepting new patients

Locations

600 E Oglethorpe Hwy
Ste B
Hinesville, GA 31313
Phone (407) 907-2077

11909 McAuley Dr
Ste A2
Savannah, GA 31419
Phone (912) 925-3767

5102 Paulsen St
Bldg 2
Savannah, GA 31405
Phone (912) 954-8331

836 E 65th St
Ste 22
Savannah, GA 31405
Phone (912) 819-7878

16741 Highway 67
Ste A
Statesboro, GA 30458
Phone (912) 623-2391

Interoperability endpoints

  • Direct secure messaging: halesjen@direct.sjchs.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1600905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788220800000",
    "number": "1285241265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "836 E 65TH ST STE 22",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314054493",
            "telephone_number": "912-414-6034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11909 MCAULEY DR STE 1002A",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314191793",
            "telephone_number": "912-354-8331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALES",
        "first_name": "JENNIFER",
        "middle_name": "ANN",
        "credential": "NP-C #F05200177",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-24",
        "last_updated": "2026-09-01",
        "certification_date": "2026-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN196020",
            "primary": true
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "GA",
            "license": "RN196020",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Savannah, GA

Sources for this page

Verify at the official NPI Registry.