Liz Hutley, NP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

RN149443 Issued in GA

Practice address

200 Donehoo St
Statesboro, GA 30458-5169

Phone

(912) 764-8441

NPI assigned

Mar 6, 2021

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Ogeechee Area Hospice Inc.

  • Community Based Hospice Care Agency
  • Statesboro, GA
  • NPI 1003813577
  Medicare reassignment NPD

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

{
    "created_epoch": "1614988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614988800000",
    "number": "1649865197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 DONEHOO ST",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304585169",
            "telephone_number": "912-764-8441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 DONEHOO ST",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304585169",
            "telephone_number": "912-764-8441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUTLEY",
        "first_name": "LIZ",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-06",
        "last_updated": "2021-03-06",
        "certification_date": "2021-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "GA",
            "license": "RN149443",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jadeshala Humphries, LPC
• Niki Humphries
• Nancy a. Hurlock, AGPCNP-BC
• Anita A Hutcheson, LPN
• Bridgette Hutchins
• I V Care of Middle Georgia Inc
• Chizoba Ifeorah
• Sajeel Ijaz, M.D.
• Rao Prasad Immaneni, M.D.
• Independent Physical Therapy of Ga, LLC

• Gerontology Nurse Practitioner in Statesboro, GA
• Providers in Statesboro, GA by specialty
• Gerontology Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2021; 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.