Individual provider Active NPI

Nancy Cheek Walraven

  • Registered Nurse
  • Milledgeville, GA
National Provider Identifier
1548880800
Registry record updated Apr 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN241019 Issued in GA
Practice address
231 W Hancock St
Milledgeville, GA 31061-3375
Phone
(404) 273-6143
NPI assigned
Apr 16, 2020
Last updated
Apr 16, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN241019 GA Primary

Addresses

Primary practice location

231 W Hancock St
Milledgeville, GA 31061-3375

Mailing address

1115 Fairview Rd
Brooks, GA 30205-2814
Phone (404) 273-6143

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
I20240620002773 GA Practitioner - Nurse Practitioner 8729521554 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
May accept Medicare assignment
Group practices
Brightmoor Hospice LLCGroup PAC ID 7517997141, 6 clinicians

Practice addresses (Care Compare)

3247 Newnan Rd
Griffin, GA 30223-7114
Phone (770) 467-9930

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Brightmoor Hospice, LLC CurrentSince Mar 29, 2024 Accepting new patients

Locations

3247 Newnan Rd
Griffin, GA 30223
Phone (770) 467-9930

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1586995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586995200000",
    "number": "1548880800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1115 FAIRVIEW RD",
            "city": "BROOKS",
            "state": "GA",
            "postal_code": "302052814",
            "telephone_number": "404-273-6143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "231 W HANCOCK ST",
            "city": "MILLEDGEVILLE",
            "state": "GA",
            "postal_code": "310613375",
            "telephone_number": "404-273-6143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALRAVEN",
        "first_name": "NANCY",
        "middle_name": "CHEEK",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-16",
        "last_updated": "2020-04-16",
        "certification_date": "2020-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GA",
            "license": "RN241019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milledgeville, GA

Sources for this page

Verify at the official NPI Registry.