Joshua Caleb Vining, FNP
Individual provider Active NPI Nurse Practitioner · Lenox, GA
NPI 1487260949 · NPPES record last updated Jul 12, 2021
Key facts
- NPI
- 1487260949
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- RN231071 (GA)
- Practice address
- 15 S Railroad St
Lenox, GA 31637-7424 - Phone
- (229) 999-1778
- Fax
- (295) 464-6122
- NPI assigned
- Sep 21, 2020
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20201109001610 | GA | Practitioner - Nurse Practitioner | 7719397496 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN231071 | GA | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southwest Georgia Rehab, Inc | Current |
Accepting new patients | |
| Magnolia Urgent Care & Wellness Center LLC | Current |
Accepting new patients |
Locations
201 W Marion Ave
Nashville, GA 31639
Phone (229) 686-1886
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | RN231071 | GA | Yes |
Addresses
Primary practice location
15 S Railroad St
Lenox, GA 31637-7424
Mailing address
401 Mall Blvd Ste 202E
Savannah, GA 31406-4834
Phone (912) 349-4945
Other practice location 1
247 Northside Dr Ste B
Valdosta, GA 31602-1892
Phone (229) 253-1206
Other providers in Lenox, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 12, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.