Individual provider Active NPI

Johanna Mathews

  • Acute Care Nurse Practitioner
  • Savannah, GA
National Provider Identifier
1538849641
Registry record updated Jul 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
RN160147 Issued in GA
Practice address
4700 Waters Ave
Savannah, GA 31404-6220
Phone
(561) 997-0821
NPI assigned
Jul 24, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 24, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X RN160147 GA Primary

Addresses

Primary practice location

4700 Waters Ave
Savannah, GA 31404-6220

Mailing address

110 Okatee Dr
Savannah, GA 31410-3812
Phone (912) 659-4656

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
I20240102002346 GA Practitioner - Nurse Practitioner 2860842929 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Intensive Care Consortium IncGroup PAC ID 0244269413, 485 clinicians

Practice addresses (Care Compare)

4700 Waters Ave
Savannah, GA 31404-6220
Phone (912) 350-8000

Hospital & facility affiliations

  • Savannah Health Services LLC Dba Memorial Health University Medical Center Hospital, Savannah, GA, CCN 110036

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Intensive Care Consortium Inc CurrentSince Nov 8, 2023 Accepting new patients

Locations

3651 Wheeler Rd
Augusta, GA 30909
Phone (706) 651-3232

4700 Waters Ave
Savannah, GA 31404
Phone (912) 273-1100

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

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 1

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": "1690156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690156800000",
    "number": "1538849641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 OKATEE DR",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314103812",
            "telephone_number": "912-659-4656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 WATERS AVE",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314046220",
            "telephone_number": "561-997-0821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHEWS",
        "first_name": "JOHANNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-07-24",
        "last_updated": "2023-07-24",
        "certification_date": "2023-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "GA",
            "license": "RN160147",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Savannah, GA

Sources for this page

Verify at the official NPI Registry.