Individual provider Active NPI

Traci Jo Parillo, FNP-C

  • Family Nurse Practitioner
  • Statesboro, GA
National Provider Identifier
1457968307
Registry record updated Aug 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN214062 Issued in GA
Practice address
421 Page Place Road
Statesboro, GA 30458-9050
Phone
(912) 259-9619
Fax
(912) 259-9618
NPI assigned
Sep 24, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2026

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 RN214062 GA Primary

Addresses

Primary practice location

421 Page Place Road
Statesboro, GA 30458-9050

Mailing address

421 Page Place Rd
Statesboro, GA 30458-9050
Phone (912) 259-9619

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
I20210208000308 GA Practitioner - Nurse Practitioner 3274947031 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
May accept Medicare assignment
Group practices
Thrive Health and Wellness LLCGroup PAC ID 0749665644, 3 clinicians

Practice addresses (Care Compare)

421 Page Place Rd
Statesboro, GA 30458-9050
Phone (478) 232-8318

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Hospital Authority of Candler County Current Accepting new patients
Thrive Health and Wellness LLC CurrentSince Sep 27, 2023 Accepting new patients
Hospital Authority of Candler County CurrentSince Nov 29, 2021 Accepting new patients
Hospital Authority of Candler County CurrentSince Nov 29, 2021 Accepting new patients
Hospital Authority of Candler County Past Accepting new patients
Hospital Authority of Candler County Past Accepting new patients

Locations

10 Doctors St
Metter, GA 30439
Phone (912) 685-5715

637 S Lewis St
Metter, GA 30439
Phone (912) 685-1800

400 Cedar St
Metter, GA 30439
Phone (912) 685-1726

421 Page Place Rd
Statesboro, GA 30458
Phone (478) 232-8318

1058 Bermuda Run
Statesboro, GA 30458
Phone (912) 871-7100

Organizations & group practices 6

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": "1600905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787616000000",
    "number": "1457968307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "421 PAGE PLACE RD",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304589050",
            "telephone_number": "912-259-9619",
            "fax_number": "912-259-9618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "421 PAGE PLACE ROAD",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304589050",
            "telephone_number": "912-259-9619",
            "fax_number": "912-259-9618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARILLO",
        "first_name": "TRACI",
        "middle_name": "JO",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-24",
        "last_updated": "2026-08-25",
        "certification_date": "2026-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN214062",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Statesboro, GA

Sources for this page

Verify at the official NPI Registry.