Individual provider Active NPI

Janna Phillips, FNP-C

  • Family Nurse Practitioner
  • McRae, GA
National Provider Identifier
1477833770
Registry record updated Oct 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN-NP133630 Issued in GA
Practice address
160 S First Ave
MC Rae, GA 31055-3334
Phone
(731) 394-1145
NPI assigned
Aug 18, 2011
Last updated
Oct 7, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 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 APRN-NP133630 GA Primary

Addresses

Primary practice location

160 S First Ave
MC Rae, GA 31055-3334

Mailing address

160 S First Ave
MC Rae Helena, GA 31055-3334
Phone (229) 868-6473

Other identifiers 2

IdentifierTypeStateIssuer
00479267MedicaidMS
003125577AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, MS2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20120828000763 GA Practitioner - Nurse Practitioner 7517114499 Reassigns benefits to 1 organization
I20140919002238 MS Practitioner - Nurse Practitioner 7517114499 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APRN-NP133630GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
South Central Clinics, Inc CurrentSince Jul 1, 2014 Accepting new patients
Douglas Medical Specialist CurrentSince Aug 6, 2012 Accepting new patients
South Central Clinics, Inc. CurrentSince Jul 1, 2014 Accepting new patients
South Central Clinics, Inc Current Accepting new patients

Locations

200 Doctors Dr
Ste N
Douglas, GA 31533
Phone (912) 384-3338

1203 B Ave
Ellisville, MS 39437
Phone (601) 477-8553

Organizations & group practices 4

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": "1313625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791331200000",
    "number": "1477833770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 S FIRST AVE",
            "city": "MC RAE HELENA",
            "state": "GA",
            "postal_code": "310553334",
            "telephone_number": "229-868-6473",
            "fax_number": "229-868-5229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 S FIRST AVE",
            "city": "MC RAE",
            "state": "GA",
            "postal_code": "310553334",
            "telephone_number": "731-394-1145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "JANNA",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-18",
        "last_updated": "2026-10-07",
        "certification_date": "2026-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "APRN-NP133630",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00479267",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003125577A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in McRae, GA

Sources for this page

Verify at the official NPI Registry.