Sally W Poole, NPRN FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN045012NP Issued in GA

Practice address

818 Saint Sebastian Way
Suite 200
Augusta, GA 30901-2651

Phone

(706) 774-5145

Fax

(706) 774-5147

NPI assigned

Feb 22, 2007

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

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1639204746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "324 OLD SALEM WAY",
            "city": "MARTINEZ",
            "state": "GA",
            "postal_code": "309079078",
            "telephone_number": "706-855-5672",
            "fax_number": "706-774-5147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "818 SAINT SEBASTIAN WAY",
            "address_2": "SUITE 200",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309012651",
            "telephone_number": "706-774-5145",
            "fax_number": "706-774-5147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POOLE",
        "first_name": "SALLY",
        "middle_name": "W",
        "name_prefix": "Ms.",
        "credential": "NPRN FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN045012NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jose Raul Ponte Jr., MD
• Charva Patrece Poole, M.D.
• Kayla Poole
• Raven Poole
• Richard Matthew Poole, D.O.
• Thomas K Poore, DDS MS
• Brandon Jay Pope, MD, PHD
• David Daniel Pope, PHARM.D., CDM
• John Charles Pope III, PA-C
• Richard William Pope, MD

• Family Nurse Practitioner in Augusta, GA
• Providers in Augusta, 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 Jul 8, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.