Individual provider Active NPI

Andrea Benford, FNP

  • Family Nurse Practitioner
  • Savannah, GA
National Provider Identifier
1437657905
Registry record updated Jan 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
213533 Issued in GA
Practice address
1004 Memorial LN
Savannah, GA 31410-1254
Phone
(912) 234-2273
NPI assigned
Jan 30, 2018
Last updated
Jan 30, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2018

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 213533 GA Primary

Addresses

Primary practice location

1004 Memorial LN
Savannah, GA 31410-1254

Mailing address

1202 E de Renne Ave
Savannah, GA 31406-2016

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
I20190116003708 GA Practitioner - Nurse Practitioner 2062758717 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellstar Medical Group LLCGroup PAC ID 6709065402, 3,059 clinicians

Practice addresses (Care Compare)

2450 Old Milton Pkwy
Alpharetta, GA 30009-2520

5150 Stilesboro N W Rd
Suite 220
Kennesaw, GA 30152-7742
Phone (770) 424-8222

8901 Stonebridgde Blvd
Suite 100
Douglasville, GA 30134-2253
Phone (943) 202-7100

Merit-based Incentive Payment System (MIPS)

Final score
93.93 of 100Reported as apm
Quality
82.14
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
213533GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Atlanta Ropheka Medical Center, PC CurrentSince Nov 17, 2018 Accepting new patients
Wellstar Medical Group, LLC CurrentSince Nov 1, 2019 Accepting new patients
Wellstar Medical Group, LLC Current Accepting new patients

Locations

5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222

217 Medical Way
Riverdale, GA 30274
Phone (770) 991-9227

6781 Londonderry Way
Ste 3
Union City, GA 30291
Phone (770) 731-2933

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/3a26afd9-920c-4709-8b6b-367ca80f62e3/

Organizations & group practices 3

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": "1517270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517270400000",
    "number": "1437657905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1202 E DE RENNE AVE",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314062016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1004 MEMORIAL LN",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314101254",
            "telephone_number": "912-234-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENFORD",
        "first_name": "ANDREA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-30",
        "last_updated": "2018-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "213533",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Savannah, GA

Sources for this page

Verify at the official NPI Registry.