Individual provider Active NPI

Karen E. Bamberg, ANP-BC

  • Adult Health Nurse Practitioner
  • Jesup, GA
National Provider Identifier
1437409331
Registry record updated Sep 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
RN118292 Issued in GA
Practice address
113 Colonial Way
Jesup, GA 31545-0122
Phone
(912) 427-7350
Fax
(912) 427-7315
NPI assigned
Sep 18, 2012
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

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.

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Robert a Pumpelly IV MD PC 2 clinicians

Practice addresses (Care Compare)

124 Memorial Dr
Jesup, GA 31545-0101
Phone (912) 427-4413

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
I20131009000679 GA Practitioner - Nurse Practitioner 0840424776 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN118292GAMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Robert a Pumpelly IV MD PC CurrentSince Jul 12, 2013 Accepting new patients

Locations

124 Memorial Dr
Jesup, GA 31545
Phone (866) 359-8346

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X RN118292 GA Primary

Addresses

NPPES NPI Registry

Primary practice location

113 Colonial Way
Jesup, GA 31545-0122

Mailing address

65 Aldridge Rd
Jesup, GA 31545-7067
Phone (912) 427-7350

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 18, 2012.

{
    "created_epoch": "1347926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347926400000",
    "number": "1437409331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 ALDRIDGE RD",
            "city": "JESUP",
            "state": "GA",
            "postal_code": "315457067",
            "telephone_number": "912-427-7350",
            "fax_number": "912-427-7315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 COLONIAL WAY",
            "city": "JESUP",
            "state": "GA",
            "postal_code": "315450122",
            "telephone_number": "912-427-7350",
            "fax_number": "912-427-7315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAMBERG",
        "first_name": "KAREN",
        "middle_name": "E.",
        "name_prefix": "Mrs.",
        "credential": "ANP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-09-18",
        "last_updated": "2012-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "GA",
            "license": "RN118292",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jesup, GA

Sources for this page

Verify at the official NPI Registry.