Individual provider Active NPI

Nicole Ann Hiller, NP

  • Family Nurse Practitioner
  • Brunswick, GA
National Provider Identifier
1497083125
Registry record updated Oct 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
195040 Issued in GA
Practice address
2500 Starling St
Suite 506
Brunswick, GA 31520-4265
Phone
(912) 466-5506
NPI assigned
Nov 18, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN195040 GA
Family Nurse Practitioner 363LF0000X 195040 GA Primary

Addresses

Primary practice location

2500 Starling St
Suite 506
Brunswick, GA 31520-4265

Mailing address

2500 Starling St
Suite 506
Brunswick, GA 31520-4265
Phone (912) 466-5506

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
I20131106000167 GA Practitioner - Nurse Practitioner 3476788175 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Cincinnati College of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Effingham Rehab Services, LLCGroup PAC ID 5597752063, shared by 3 NPIs, 143 clinicians
Cooperative Healthcare Services IncGroup PAC ID 9830093640, 235 clinicians

Practice addresses (Care Compare)

1390 Boone Ave Ext
Suite A23
Kingsland, GA 31548-6515
Phone (419) 221-3717

2060 Dan Proctor Dr
Saint Marys, GA 31558-3895

2415 Parkwood Dr
Brunswick, GA 31520-4722
Phone (912) 466-4079

Hospital & facility affiliations

  • Southeast Georgia Health System -- Camden Campus Hospital, Saint Marys, GA, CCN 110146
  • Southeast Georgia Health System- Brunswick Campus Hospital, Brunswick, GA, CCN 110025

Merit-based Incentive Payment System (MIPS)

Final score
76.36 of 100Reported as group
Quality
46.72
Promoting interoperability
99
Improvement activities
40
Cost
75.31

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN195040GAMDRegistered Nurse
195040GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cooperative Healthcare Services Inc CurrentSince Oct 14, 2013 Accepting new patients

Locations

2415 Parkwood Dr
Brunswick, GA 31520
Phone (912) 466-4079

2500 Starling St
Ste 506
Brunswick, GA 31520
Phone (912) 264-9670

Interoperability endpoints

  • Direct secure messaging: nhiller@secure.sghsmessaging.org

Organizations & group practices 1

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1258502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1381276800000",
    "number": "1497083125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 STARLING ST",
            "address_2": "SUITE 506",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315204265",
            "telephone_number": "912-466-5506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 STARLING ST",
            "address_2": "SUITE 506",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315204265",
            "telephone_number": "912-466-5506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HILLER",
        "first_name": "NICOLE",
        "middle_name": "ANN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-18",
        "last_updated": "2013-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GA",
            "license": "RN195040",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "195040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brunswick, GA

Sources for this page

Verify at the official NPI Registry.