Individual provider Active NPI

Jane Adair Camacho Robertson, MBA, MSN, FNP-BC

  • Nurse Practitioner
  • Savannah, GA
National Provider Identifier
1548764111
Registry record updated Mar 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN235869 Issued in GA
Practice address
4750 Waters Ave Ste 302
Savannah, GA 31404-6268
Phone
(912) 350-5970
Fax
(912) 350-3374
NPI assigned
Mar 20, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN235869 GA
Nurse Practitioner 363L00000X RN235869 GA Primary

Addresses

Primary practice location

4750 Waters Ave Ste 302
Savannah, GA 31404-6268

Mailing address

45 Rosemont CT
Richmond Hill, GA 31324-3731
Phone (912) 657-0281

Other practice location 1

412 US Highway 80 SW
Pooler, GA 31322-2541
Phone (912) 348-2302

Other practice location 2

460 Mall Blvd
Savannah, GA 31406-4801
Phone (912) 354-3400

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
I20220412002329 GA Practitioner - Nurse Practitioner 3678969078 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Savannah Multispecialty Associates LLCGroup PAC ID 3678836558, 129 clinicians

Practice addresses (Care Compare)

4750 Waters Ave
Suite 302
Savannah, GA 31404-6268
Phone (912) 350-7020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Business Administration, Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN235869GAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Savannah Multispecialty Associates, LLC CurrentSince Apr 4, 2022 Accepting new patients

Locations

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

4750 Waters Ave
Ste 302
Savannah, GA 31404
Phone (912) 350-3367

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.

NPI Registry JSON

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

{
    "created_epoch": "1521504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648425600000",
    "number": "1548764111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 ROSEMONT CT",
            "city": "RICHMOND HILL",
            "state": "GA",
            "postal_code": "313243731",
            "telephone_number": "912-657-0281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4750 WATERS AVE STE 302",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314046268",
            "telephone_number": "912-350-5970",
            "fax_number": "912-350-3374"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "412 US Highway 80 SW",
            "address_purpose": "LOCATION",
            "city": "Pooler",
            "state": "GA",
            "postal_code": "313222541",
            "country_code": "US",
            "telephone_number": "912-348-2302",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "460 Mall Blvd",
            "address_purpose": "LOCATION",
            "city": "Savannah",
            "state": "GA",
            "postal_code": "314064801",
            "country_code": "US",
            "telephone_number": "912-354-3400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROBERTSON",
        "first_name": "JANE ADAIR",
        "middle_name": "CAMACHO",
        "credential": "MBA, MSN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-20",
        "last_updated": "2022-03-28",
        "certification_date": "2022-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN235869",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN235869",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Savannah, GA

Sources for this page

Verify at the official NPI Registry.