Individual provider Active NPI

Gina Winnette, MSN, APRN, FNP-BC

  • Family Nurse Practitioner
  • Statesboro, GA
National Provider Identifier
1417274358
Registry record updated Dec 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN152637 Issued in GA
Practice address
204 S Main St
Statesboro, GA 30458-0723
Phone
(912) 662-6501
Fax
(912) 681-1012
NPI assigned
May 3, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 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 RN152637 GA Primary

Addresses

Primary practice location

204 S Main St
Statesboro, GA 30458-0723

Mailing address

204 S Main St
Statesboro, GA 30458-0723
Phone (912) 662-6501

Other identifiers 1

IdentifierTypeStateIssuer
668134657AMedicaidGA

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
I20101105000406 GA Practitioner - Nurse Practitioner 0244424018 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
May accept Medicare assignment
Group practices
Bulloch County Board of HealthGroup PAC ID 5193710481, 4 clinicians
Toombs County Board of HealthGroup PAC ID 4183612732, 3 clinicians

Practice addresses (Care Compare)

3 W Altman St
Statesboro, GA 30458-5212
Phone (912) 764-2402

714 NW Broad St
Lyons, GA 30436-5648
Phone (912) 526-8108

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN152637GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bulloch County Board of Health CurrentSince Jul 10, 2018 Accepting new patients
Coffee County Board of Health CurrentSince Jul 10, 2018 Accepting new patients
Toombs County Board of Health CurrentSince Jul 10, 2018 Accepting new patients
Coffee County Board of Health Current Accepting new patients
Bulloch County Board of Health CurrentSince Jul 10, 2018 Accepting new patients
Ware County Board of Health CurrentSince Dec 2, 2022 Accepting new patients
Toombs County Wellness Center CurrentSince Jul 10, 2018 Accepting new patients
Candler County Board of Health Past Accepting new patients

Locations

310 Bryan St W
Douglas, GA 31533
Phone (912) 389-4204

1003 Shirley Ave
Douglas, GA 31533
Phone (912) 389-4204

714 NW Broad St
Lyons, GA 30436
Phone (912) 526-8108

714 NW Broad St
#B
Lyons, GA 30436

3 W Altman St
Statesboro, GA 30458
Phone (912) 764-2402

1102 Plant Ave
Waycross, GA 31501
Phone (912) 285-6002

1101 Church St
Waycross, GA 31501
Phone (912) 285-6010

Interoperability endpoints

  • Direct secure messaging: gina.winnette1@gadirect.net

Organizations & group practices 8

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": "1272844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449014400000",
    "number": "1417274358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 S MAIN ST",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304580723",
            "telephone_number": "912-662-6501",
            "fax_number": "912-681-1012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 S MAIN ST",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304580723",
            "telephone_number": "912-662-6501",
            "fax_number": "912-681-1012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WINNETTE",
        "first_name": "GINA",
        "name_prefix": "Mrs.",
        "credential": "MSN, APRN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-03",
        "last_updated": "2015-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN152637",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "668134657A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Statesboro, GA

Sources for this page

Verify at the official NPI Registry.