Heather N Bumgardner, NURSE PRACTITIONER

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

RN192027 Issued in GA

Practice address

7306 Ga Highway 21
Suite 106
Port Wentworth, GA 31407-9274

Phone

(912) 826-1500

Fax

(912) 826-1531

NPI assigned

Jul 22, 2014

Sex

Female

Sole proprietor

No

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

Practice roles

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.

• Effingham Hospital, Inc.

  • Otolaryngology Physician
  • Springfield, GA
  • NPI 1881588028
  NPD (past)

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

{
    "created_epoch": "1405987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478649600000",
    "number": "1679980668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 W PERRY ST",
            "address_2": "SUITE 106",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314013951",
            "telephone_number": "912-826-1500",
            "fax_number": "912-826-1531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7306 GA HIGHWAY 21",
            "address_2": "SUITE 106",
            "city": "PORT WENTWORTH",
            "state": "GA",
            "postal_code": "314079274",
            "telephone_number": "912-826-1500",
            "fax_number": "912-826-1531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUMGARDNER",
        "first_name": "HEATHER",
        "middle_name": "N",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-22",
        "last_updated": "2016-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "GA",
            "license": "RN192027",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Achieve Your Peace Counseling
• Kiyoro Terrie Addison
• Chakita Miesha Allen, CFA
• Brittany Bell
• Care From the Start Homecare Agency, LLC
• Aisha Carrasquilla, LPN
• Dawn Rachelle Carter
• Angel Clark-Kennedy
• Amanda Clementz, PT

• All providers in Port Wentworth, GA
• Adult Health Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2016; 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.