Individual provider Active NPI

Carolyn Elizabeth Heard, NP

  • Nurse Practitioner
  • Bainbridge, GA
National Provider Identifier
1679449946
Registry record updated Oct 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN-NP295028 Issued in GA
Practice address
1500 E Shotwell St
Bainbridge, GA 39819-4294
Phone
(229) 246-3500
NPI assigned
Oct 14, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363L00000X APRN-NP295028 GA Primary

Addresses

Primary practice location

1500 E Shotwell St
Bainbridge, GA 39819-4294

Mailing address

124 Mimosa LN
Bainbridge, GA 39819-6591
Phone (229) 309-6902

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
I20260121004200 GA Practitioner - Nurse Practitioner 6406333442 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1138 Austin St
North Augusta, SC 29841-4301

PO Box
Suite 60969
Savannah, GA 31420

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN-NP295028GAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hospital Authority of the City of Bainbridge and Decatur County Georgi CurrentSince Dec 1, 2025 Accepting new patients
Hospital Authority of the City of Bainbridge and Decatur County Single Specialty CurrentSince Dec 1, 2025 Accepting new patients

Locations

603 Wheat Ave
Ste 450
Bainbridge, GA 39819
Phone (229) 243-7707

1500 E Shotwell St
Bainbridge, GA 39819
Phone (229) 243-6100

Organizations & group practices 2

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": "1760400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760400000000",
    "number": "1679449946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 MIMOSA LN",
            "city": "BAINBRIDGE",
            "state": "GA",
            "postal_code": "398196591",
            "telephone_number": "229-309-6902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 E SHOTWELL ST",
            "city": "BAINBRIDGE",
            "state": "GA",
            "postal_code": "398194294",
            "telephone_number": "229-246-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEARD",
        "first_name": "CAROLYN",
        "middle_name": "ELIZABETH",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-10-14",
        "last_updated": "2025-10-14",
        "certification_date": "2025-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "APRN-NP295028",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bainbridge, GA

Sources for this page

Verify at the official NPI Registry.