Organization Active NPI

Golden Isles Family Healthcare, LLC

  • Primary Care Nurse Practitioner
  • Brunswick, GA
National Provider Identifier
1346874005
Registry record updated Jan 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
Legal business name
GOLDEN ISLES FAMILY HEALTHCARE, LLC
Practice address
3212 Shrine Rd
Brunswick, GA 31520-4353
Phone
(912) 289-7004
Fax
(912) 289-7004
NPI assigned
Mar 2, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2023

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

Authorized official

Name
Kay Stokes
Title
Auth Official
Phone
(912) 289-7004

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP2300X Primary

Addresses

Primary practice location

3212 Shrine Rd
Brunswick, GA 31520-4353

Mailing address

3212 Shrine Rd
Brunswick, GA 31520-4353
Phone (912) 289-7004

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200617003239 GA Part B Supplier - Clinic/Group Practice 5991127060 Receives reassigned benefits from 5 practitioners
Practice locations: Brunswick, GA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D2180084Golden Isles Family Healthcare, LLC3212 Shrine Road, Brunswick, GA 31520Certificate of waiverMar 5, 2028

National Provider Directory

National Provider Directory

Locations

3010 Altama Ave
Brunswick, GA 31520
Phone (912) 266-8140

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1583107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1672704000000",
    "number": "1346874005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3212 SHRINE RD",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315204353",
            "telephone_number": "912-289-7004",
            "fax_number": "912-289-7004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3212 SHRINE RD",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315204353",
            "telephone_number": "912-289-7004",
            "fax_number": "912-289-7004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOLDEN ISLES FAMILY HEALTHCARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-02",
        "last_updated": "2023-01-03",
        "certification_date": "2022-12-19",
        "status": "A",
        "authorized_official_last_name": "STOKES",
        "authorized_official_first_name": "KAY",
        "authorized_official_title_or_position": "AUTH OFFICIAL",
        "authorized_official_telephone_number": "912-289-7004"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brunswick, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.