Individual provider Active NPI

Nicole Dutton-Andrews, FNP-BC

  • Family Nurse Practitioner
  • Hinesville, GA
National Provider Identifier
1346006715
Registry record updated Feb 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
213747 Issued in GA
Practice address
455 S Main St
Hinesville, GA 31313-4353
Phone
(912) 369-9400
NPI assigned
Feb 23, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 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 213747 GA Primary

Addresses

Primary practice location

455 S Main St
Hinesville, GA 31313-4353

Mailing address

115 Veterans Dr
Glennville, GA 30427-3051
Phone (912) 271-5324

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
I20240416000775 GA Practitioner - Nurse Practitioner 0143669739 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
213747GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hospital Authority of Liberty County CurrentSince Apr 1, 2024 Accepting new patients
Hospital Authority of Liberty County CurrentSince Apr 1, 2024 Accepting new patients

Locations

462 Elma G Miles Pkwy
Hinesville, GA 31313
Phone (888) 829-0068

455 S Main St
Ste 104
Hinesville, GA 31313
Phone (912) 368-6226

455 S Main St
Ste 203
Hinesville, GA 31313
Phone (912) 876-3552

Organizations & group practices 2

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": "1708646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708646400000",
    "number": "1346006715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 VETERANS DR",
            "city": "GLENNVILLE",
            "state": "GA",
            "postal_code": "304273051",
            "telephone_number": "912-271-5324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 S MAIN ST",
            "city": "HINESVILLE",
            "state": "GA",
            "postal_code": "313134353",
            "telephone_number": "912-369-9400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUTTON-ANDREWS",
        "first_name": "NICOLE",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-23",
        "last_updated": "2024-02-23",
        "certification_date": "2024-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "213747",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hinesville, GA

Sources for this page

Verify at the official NPI Registry.