Individual provider Active NPI

Whitney Louise Mathis, FNP-C

  • Family Nurse Practitioner
  • Augusta, GA
National Provider Identifier
1417753310
Registry record updated Mar 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F12240020 Issued in SC
Practice address
2011 Windsor Spring Rd
Augusta, GA 30906-4957
Phone
(706) 798-1700
NPI assigned
Feb 21, 2025
Last updated
Mar 3, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2025

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 F12240020 SC Primary

Addresses

Primary practice location

2011 Windsor Spring Rd
Augusta, GA 30906-4957

Mailing address

124 Hunters Xing
North Augusta, SC 29841-6605
Phone (803) 349-6764

Other practice location 1

1701 Magnolia Way Ste 102
Augusta, GA 30909-9484
Phone (706) 992-6699

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20250604002542 SC Practitioner - Nurse Practitioner 8527577113 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
F12240020SCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Molina Care Connections, LLC. CurrentSince Jun 2, 2025 Accepting new patients
Center for Primary Care PC PastSince Jun 15, 2002 Accepting new patients

Locations

200 Oceangate
Ste 100
Long Beach, CA 90802
Phone (562) 435-3666

4105 Faber Place Dr
Ste 120
North Charleston, SC 29405
Phone (562) 549-3966

Interoperability endpoints

  • Direct secure messaging: wmathis19439@direct-prd.molinahealthcare.com

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

NPI Registry JSON

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

{
    "created_epoch": "1740096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740960000000",
    "number": "1417753310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 HUNTERS XING",
            "city": "NORTH AUGUSTA",
            "state": "SC",
            "postal_code": "298416605",
            "telephone_number": "803-349-6764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2011 WINDSOR SPRING RD",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309064957",
            "telephone_number": "706-798-1700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1701 Magnolia Way Ste 102",
            "address_purpose": "LOCATION",
            "city": "Augusta",
            "state": "GA",
            "postal_code": "309099484",
            "country_code": "US",
            "telephone_number": "706-992-6699",
            "fax_number": "706-868-5027",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATHIS",
        "first_name": "WHITNEY",
        "middle_name": "LOUISE",
        "name_prefix": "Ms.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-02-21",
        "last_updated": "2025-03-03",
        "certification_date": "2025-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "F12240020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, GA

Sources for this page

Verify at the official NPI Registry.