Individual provider Active NPI

Tasha N Schultz, NP

  • Family Nurse Practitioner
  • Richmond Hill, GA
National Provider Identifier
1679710040
Registry record updated Sep 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN220642 Issued in GA
Practice address
2324 US Highway 17
Richmond Hill, GA 31324-3398
Phone
(912) 756-2531
NPI assigned
Jan 7, 2009
Last updated
Sep 12, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN220642 GA Primary

Addresses

Primary practice location

2324 US Highway 17
Richmond Hill, GA 31324-3398

Mailing address

100 Tupelo TRL
Richmond Hill, GA 31324-6911
Phone (225) 603-9535

Other identifiers 3

IdentifierTypeStateIssuer
201316101MedicaidTX
201316102MedicaidTX
201316103MedicaidTX

Other names 1

  • Tasha N Jackson Former name

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
I20121205000092 GA Practitioner - Nurse Practitioner 3375690282 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wound Care Clinic - Esu, Inc.Group PAC ID 9436178910, 4 clinicians
Procare Wellness Network IncGroup PAC ID 0547644841, 13 clinicians

Practice addresses (Care Compare)

1215 US Hwy 80 E
Suite 700
Pooler, GA 31322-9566
Phone (912) 998-0040

340 Eisenhower Dr
BLDG 500
Savannah, GA 31406-1600
Phone (912) 348-3818

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN220642GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Guardian Biologics LLC CurrentSince Dec 16, 2024 Accepting new patients
Wound Care Clinic - Esu, Inc. CurrentSince Dec 1, 2022 Accepting new patients
Health Services of Central Georgia, Inc CurrentSince Nov 1, 2012 Accepting new patients
Regional Healthcare Group LLC CurrentSince Dec 16, 2024 Accepting new patients
Mobile Wound Care Solutions LLC CurrentSince Feb 23, 2025 Accepting new patients
Hyperbaric & Woundcare Inc CurrentSince Mar 1, 2026 Accepting new patients
Central Georiga Fertility Institute PastSince Nov 1, 2012 Accepting new patients

Locations

770 Pine St
Ste 140
Macon, GA 31201
Phone (478) 633-1821

1120 Morningside Dr
Perry, GA 31069
Phone (478) 218-1706

1215 US Highway 80 E
Ste 700
Pooler, GA 31322
Phone (912) 998-0040

Organizations & group practices 8

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": "1231286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473638400000",
    "number": "1679710040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 TUPELO TRL",
            "city": "RICHMOND HILL",
            "state": "GA",
            "postal_code": "313246911",
            "telephone_number": "225-603-9535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2324 US HIGHWAY 17",
            "city": "RICHMOND HILL",
            "state": "GA",
            "postal_code": "313243398",
            "telephone_number": "912-756-2531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHULTZ",
        "first_name": "TASHA",
        "middle_name": "N",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-07",
        "last_updated": "2016-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN220642",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201316101",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201316102",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201316103",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TASHA",
            "last_name": "JACKSON",
            "middle_name": "N",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Richmond Hill, GA

Sources for this page

Verify at the official NPI Registry.