Individual provider Active NPI

Pamela Lynn Stewart, FNP

  • Family Nurse Practitioner
  • Savannah, GA
National Provider Identifier
1528546652
Registry record updated Feb 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN130372 Issued in GA
Practice address
1602 Drayton St
Savannah, GA 31401-7526
Phone
(912) 651-2587
Fax
(912) 651-2588
NPI assigned
Jul 31, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Registered Nurse 163WC1500X RN130372 GA
Family Nurse Practitioner 363LF0000X RN130372 GA Primary

Addresses

Primary practice location

1602 Drayton St
Savannah, GA 31401-7526

Mailing address

1602 Drayton St
Savannah, GA 31401-7526
Phone (912) 651-2587

Other practice location 1

1395 Eisenhower Dr
Savannah, GA 31406-3901
Phone (912) 356-2441

Other identifiers 1

IdentifierTypeStateIssuer
RN130372OtherGAGEORGIA BOARD OF NURSING

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
I20181207000714 GA Practitioner - Nurse Practitioner 6204170822 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN130372GAMDCommunity Health Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group of Georgia LLC CurrentSince May 1, 2019 Accepting new patients
Privia Medical Group of Georgia LLC CurrentSince May 1, 2019 Accepting new patients
Chatham County Board of Health Past Accepting new patients

Locations

101 Yorktown Dr
Ste 100
Fayetteville, GA 30214
Phone (770) 460-4285

89 Interchange Dr
Richmond Hill, GA 31324
Phone (912) 527-5301

1326 Eisenhower Dr
#1
Savannah, GA 31406
Phone (912) 691-4100

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8042/brand/1/csg/1/fhir/r4

Organizations & group practices 3

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": "1532995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740441600000",
    "number": "1528546652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1602 DRAYTON ST",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314017526",
            "telephone_number": "912-651-2587",
            "fax_number": "912-651-2588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1602 DRAYTON ST",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314017526",
            "telephone_number": "912-651-2587",
            "fax_number": "912-651-2588"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1395 Eisenhower Dr",
            "address_purpose": "LOCATION",
            "city": "Savannah",
            "state": "GA",
            "postal_code": "314063901",
            "country_code": "US",
            "telephone_number": "912-356-2441",
            "fax_number": "912-721-6919",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STEWART",
        "first_name": "PAMELA",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-31",
        "last_updated": "2025-02-25",
        "certification_date": "2025-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC1500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Community Health",
            "state": "GA",
            "license": "RN130372",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN130372",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GEORGIA BOARD OF NURSING",
            "identifier": "RN130372",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Savannah, GA

Sources for this page

Verify at the official NPI Registry.