Utrena Donsha Grant

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

178607 Issued in GA

Practice address

1707 Saint Marys Dr
Waycross, GA 31501-5207

Phone

(912) 282-1340

NPI assigned

Feb 15, 2018

Last updated

Mar 17, 2018By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Complexcare Medical Group Midwest M PLLCGroup PAC ID 1355858630, 87 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/HDCEBD

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Hospice Satilla of Memorial Hospital Inc

  dba Satilla Palliative Care

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Waycross, GA
  • NPI 1508434408
  Medicare reassignment NPD
• Integrity Health and Wellness, LLC

  • Family Medicine Physician
  • Waycross, GA
  • NPI 1881181808
  Medicare reassignment NPD
• Integrity Long Term Care LLC

  • Geriatric Medicine (Family Medicine) Physician
  • Waycross, GA
  • NPI 1376268177
  Medicare reassignment NPD
• Southland Optim Jenkins Emergency Medical Services, LLC

  • Emergency Medicine Physician
  • Millen, GA
  • NPI 1265826242
  Medicare reassignment NPD
• Truhealth, LLC

  • Nurse Practitioner
  • Parsons, TN
  • NPI 1063843951

  GA

  Medicare reassignment NPD
• Complexcare Medical Group Midwest M PLLC

  • Internal Medicine Physician
  • Novi, MI
  • NPI 1528851607
  Care Compare group
• Hospice Satilla of Memorial Hospital Inc

  • Community Based Hospice Care Agency
  • Waycross, GA
  • NPI 1609835123
  NPD
• Southland Optim Jenkins Emergency Medical Services, LLC

  dba DBA Southland Liberty Emergency Medical Services

  • Emergency Medicine Physician
  • Hinesville, GA
  • NPI 1477913580
  NPD

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

{
    "created_epoch": "1518652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1548760622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1707 SAINT MARYS DR",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "315015207",
            "telephone_number": "912-282-1340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1707 SAINT MARYS DR",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "315015207",
            "telephone_number": "912-282-1340"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1707 Saint Marys Dr",
            "address_purpose": "LOCATION",
            "city": "Waycross",
            "state": "GA",
            "postal_code": "315015207",
            "country_code": "US",
            "telephone_number": "912-282-1340",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRANT",
        "first_name": "UTRENA",
        "middle_name": "DONSHA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-02-15",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "178607",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa F Goedert, CRNA
• Hector Kevin Gonzalez Fajardo, MD
• David N Gosselin, NURSE PRACTITIONER
• Harry Grace, LPN
• Loren Rae Grace, LPC
• Billiejo Grantham
• Howard Griffin, MD
• Griffin's Prescription Shop,Inc.
• Donald Neal Griffis Jr., FNP-C
• Grayson Stuart Griffis, D.M.D.

• Family Nurse Practitioner in Waycross, GA
• Providers in Waycross, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.