Phyllis Evon Solomon, FNP
Individual provider Active NPI Family Nurse Practitioner · Statesboro, GA
NPI 1306337332 · NPPES record last updated Jul 27, 2023
Key facts
- NPI
- 1306337332
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- RN150971 (GA)
- Practice address
- 1570 Brampton Ave
Statesboro, GA 30458-0855 - Phone
- (912) 764-9196
- NPI assigned
- May 25, 2018
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 18
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- East Georgia Healthcare Center, Inc.
Practice addresses (Care Compare)
1570 Brampton Ave
Statesboro, GA 30458-0855
Phone (912) 764-9196
Hospital & facility affiliations
- East Georgia Regional Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190205001670 | GA | Practitioner - Nurse Practitioner | 3971841602 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN150971 | GA | MD | General Practice Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| East Georgia Healthcare Center, Inc. | Current | Accepting new patients | |
| East Georgia Healthcare Center, Inc. | Current |
Accepting new patients | |
| East Georgia Healthcare Center, Inc. | Current |
Accepting new patients | |
| Bulloch County Board of Health | Current |
Accepting new patients |
Locations
34 NW Broad St
Metter, GA 30439
Phone (912) 685-4040
1570 Brampton Ave
Statesboro, GA 30458
Phone (912) 764-9196
3 W Altman St
Statesboro, GA 30458
Phone (912) 764-2402
1 W Altman St
Statesboro, GA 30458
Phone (912) 764-0737
215 N Coleman St
Swainsboro, GA 30401
Phone (478) 237-2638
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Registered Nurse | 163WG0000X | RN150971 | GA | |
| Family Nurse Practitioner | 363LF0000X | RN150971 | GA | Yes |
Addresses
Primary practice location
1570 Brampton Ave
Statesboro, GA 30458-0855
Mailing address
1570 Brampton Ave
Statesboro, GA 30458-0855
Phone (912) 764-9196
Other names
- Phyliss Evon Solomon
Other providers in Statesboro, GA
- Jennifer Lynn Smith
- Julia K Smith
- Katina P Smith
- Mona Dennison Smith
- Sierra Renee Smith
- Thomas A. Sorbera
- Taylor Soucy
- South Georgia Center for Cancer Care, LLC
- South Georgia Family Medicine Associates
- South Georgia Pediatrics, P.C.
All providers in Statesboro, GA · Family Nurse Practitioner in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 27, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.