Individual provider Active NPI

Cathy Slay-Chipp, APRN-C

  • Family Nurse Practitioner
  • Brunswick, GA
National Provider Identifier
1508925272
Registry record updated Nov 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN051489 Issued in GA
Practice address
4220 Coral Park Dr
Brunswick, GA 31520-3016
Phone
(912) 275-8165
Fax
(904) 212-1632
NPI assigned
Dec 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2021

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 RN051489 GA Primary

Addresses

Primary practice location

4220 Coral Park Dr
Brunswick, GA 31520-3016

Mailing address

4862 Malabar Dr
Brunswick, GA 31520-2810
Phone (912) 230-1556

Other identifiers 1

IdentifierTypeStateIssuer
211393653BMedicaidGA

Other names 1

  • Cathy Elizabeth Slay Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Perry Park Neighborhood Clinic, Inc. CurrentSince Jun 12, 2010 Accepting new patients

Locations

2211 Bartow St
Brunswick, GA 31520
Phone (850) 210-2473

Interoperability endpoints

  • Direct secure messaging: cathy.slaychipp@gadirect.net

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.

NPI Registry JSON

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

{
    "created_epoch": "1165536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637539200000",
    "number": "1508925272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4862 MALABAR DR",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315202810",
            "telephone_number": "912-230-1556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4220 CORAL PARK DR",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315203016",
            "telephone_number": "912-275-8165",
            "fax_number": "904-212-1632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLAY-CHIPP",
        "first_name": "CATHY",
        "credential": "APRN-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-08",
        "last_updated": "2021-11-22",
        "certification_date": "2021-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN051489",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "211393653B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CATHY",
            "last_name": "SLAY",
            "middle_name": "ELIZABETH",
            "credential": "DNP, APRN-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Brunswick, GA

Sources for this page

Verify at the official NPI Registry.