Kalie Deann Mathis, NP-C

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

RN279071 Issued in GA

Practice address

505 City Blvd
Waycross, GA 31501-8003

Phone

(912) 490-2229

NPI assigned

Aug 16, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

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, 2021

Medicare assignment

May accept Medicare assignment

Group practices

Memorial Satilla Specialists, LLCGroup PAC ID 5991074957, 19 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Memorial Satilla Health Hospital, Waycross, GA, CCN 110003

Merit-based Incentive Payment System (MIPS)

Final score

91.07 of 100Reported as group

Quality

81.4

Promoting interoperability

99

Improvement activities

40

Cost

71.99

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/BICIBA
• Direct secure messaging: kalie.mathis@hca5.eclinicaldirectplus.com

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.

• Memorial Satilla Specialists, LLC

  • General Practice Physician
  • Waycross, GA
  • NPI 1295266955
  Medicare reassignment Care Compare group NPD
• Mayo Clinic Health System in Waycross, Inc.

  • Multi-Specialty Clinic/Center
  • Waycross, GA
  • NPI 1154745982
  NPD (past)
• Southeast Georgia Pediatrics

  • Primary Care Clinic/Center
  • Waycross, GA
  • NPI 1457613192
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Southeast Georgia Health Services, L.L.C.

  • Rural Acute Care Hospital
  • Waycross, GA
  • NPI 1922530468
  Care Compare affiliation

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

{
    "created_epoch": "1629072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694476800000",
    "number": "1679248124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 E WASHINGTON DR",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "315030680",
            "telephone_number": "912-548-4230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 CITY BLVD",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "315018003",
            "telephone_number": "912-490-2229"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1701 Boulevard Sq Ste D",
            "address_purpose": "LOCATION",
            "city": "Waycross",
            "state": "GA",
            "postal_code": "315018022",
            "country_code": "US",
            "telephone_number": "912-387-0445",
            "fax_number": "912-226-3513",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATHIS",
        "first_name": "KALIE",
        "middle_name": "DEANN",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-16",
        "last_updated": "2023-09-12",
        "certification_date": "2023-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "GA",
            "license": "RN279071",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN279071",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Earl T Martin, M.D.
• Kaitlyn Suzanne Martin, PTA
• Kristen Brooke Martin, APRN, FNP-C
• Virginia Martin, O.D.
• Ellisa A Mathis, FNP'C
• Scott Mathis, APRN,BC
• Diana Maurer, O.D.
• Mayo Clinic Health System in Waycross
• Mayo Clinic Health System in Waycross, Inc
• Mayo Clinic Health System in Waycross, Inc.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2023; 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.