Individual provider Active NPI

John Hillenkamp

  • Emergency Medicine Physician
  • Rincon, GA
National Provider Identifier
1487187597
Registry record updated May 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
84403 Issued in GA
Practice address
5629 Hwy 21 S
Rincon, GA 31326-9416
Phone
(912) 295-2133
Fax
(912) 295-5924
NPI assigned
Apr 5, 2017
Last updated
May 17, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Emergency Medicine Physician 207P00000X 84403 GA Primary

Addresses

Primary practice location

5629 Hwy 21 S
Rincon, GA 31326-9416

Mailing address

5629 Hwy 21 S
Rincon, GA 31326-9416
Phone (912) 295-2133

Other practice location 1

3600 Forbes Ave
Forbes Tower Plaza Suite 140
Pittsburgh, PA 15213-3410
Phone (412) 647-6340

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, GA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20191111001017 PA Practitioner - Emergency Medicine 3375811136 Reassigns benefits to 1 organization
I20200608000246 GA Practitioner - Emergency Medicine 3375811136 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
84403GAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Pittsburgh Physicians CurrentSince Oct 1, 2019 Accepting new patients
University of Pittsburgh Physicians CurrentSince Oct 1, 2019 Accepting new patients
Georgia Emergency Associates Emergency Medicine CurrentSince Jun 1, 2020 Accepting new patients
University of Pittsburgh Physicians Current Accepting new patients

Locations

5629 Highway 21 S
Rincon, GA 31326
Phone (912) 295-2133

11705 Mercy Blvd
Savannah, GA 31419
Phone (912) 819-2452

5353 Reynolds St
Savannah, GA 31405
Phone (912) 692-6172

1499 Fair Rd
Statesboro, GA 30458
Phone (912) 486-1000

1500 5th Ave
McKeesport, PA 15132
Phone (412) 664-2167

2 Hot Metal St
#One
Pittsburgh, PA 15203
Phone (412) 432-5864

200 Lothrop St
Pittsburgh, PA 15213
Phone (412) 647-3553

3600 Forbes Ave
Ste 140
Pittsburgh, PA 15213

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": "1491350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589673600000",
    "number": "1487187597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5629 HWY 21 S",
            "city": "RINCON",
            "state": "GA",
            "postal_code": "313269416",
            "telephone_number": "912-295-2133",
            "fax_number": "912-295-5924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5629 HWY 21 S",
            "city": "RINCON",
            "state": "GA",
            "postal_code": "313269416",
            "telephone_number": "912-295-2133",
            "fax_number": "912-295-5924"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3600 Forbes Ave",
            "address_2": "Forbes Tower Plaza Suite 140",
            "address_purpose": "LOCATION",
            "city": "Pittsburgh",
            "state": "PA",
            "postal_code": "152133410",
            "country_code": "US",
            "telephone_number": "412-647-6340",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HILLENKAMP",
        "first_name": "JOHN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-05",
        "last_updated": "2020-05-17",
        "certification_date": "2020-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "GA",
            "license": "84403",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rincon, GA

Sources for this page

Verify at the official NPI Registry.