Individual provider Active NPI

Katherine Ganas Harvell, FNP-BC

  • Family Nurse Practitioner
  • Waycross, GA
National Provider Identifier
1689909236
Registry record updated Nov 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN170256 Issued in GA
Practice address
1921 Alice St Ste 3a
Waycross, GA 31501-6202
Phone
(912) 283-5616
NPI assigned
Oct 14, 2009
Last updated
Nov 5, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2023

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 RN170256 GA Primary

Addresses

Primary practice location

1921 Alice St Ste 3a
Waycross, GA 31501-6202

Mailing address

5482 Meadow Wood Rd
Blackshear, GA 31516-4453
Phone (229) 300-7169

Other practice location 1

407 W Oneida St
Waycross, GA 31501-5320
Phone (912) 338-0065

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
I20100304000159 GA Practitioner - Nurse Practitioner 9537204300 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

407 W Oneida St
Waycross, GA 31501-5320
Phone (912) 338-0065

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN170256GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
South Georgia Physicians Group, LLC Family CurrentSince Jan 1, 2024 Accepting new patients
St Vincents Ambulatory Care Inc CurrentSince Oct 29, 2021 Accepting new patients
Bacon County Health Services, Inc. CurrentSince Jan 10, 2024 Accepting new patients
St Vincents Ambulatory Care Inc CurrentSince Oct 29, 2021 Accepting new patients
Bacon County Health Services, Inc. Past Accepting new patients
Bacon County Health Services, Inc. Past Accepting new patients

Locations

4205 Belfort Rd
Ste 4015
Jacksonville, FL 32216
Phone (904) 296-5691

204 E 15th St
Alma, GA 31510
Phone (912) 632-2952

205 S Wayne St
Alma, GA 31510
Phone (912) 383-9789

302 S Wayne St
Alma, GA 31510
Phone (912) 632-8961

1406 Habersham Dr
Waycross, GA 31501
Phone (912) 287-0333

1506 Alice St
Waycross, GA 31501
Phone (912) 285-3086

407 W Oneida St
Waycross, GA 31501
Phone (912) 338-0065

615 Pendleton St
Ste A
Waycross, GA 31501
Phone (912) 548-0710

Interoperability endpoints

  • Direct secure messaging: katherine.harvell@bacon.gadirect.net

Organizations & group practices 6

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1255478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699142400000",
    "number": "1689909236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5482 MEADOW WOOD RD",
            "city": "BLACKSHEAR",
            "state": "GA",
            "postal_code": "315164453",
            "telephone_number": "229-300-7169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1921 ALICE ST STE 3A",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "315016202",
            "telephone_number": "912-283-5616"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "407 W Oneida St",
            "address_purpose": "LOCATION",
            "city": "Waycross",
            "state": "GA",
            "postal_code": "315015320",
            "country_code": "US",
            "telephone_number": "912-338-0065",
            "fax_number": "912-338-0920",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARVELL",
        "first_name": "KATHERINE",
        "middle_name": "GANAS",
        "name_prefix": "Mrs.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-14",
        "last_updated": "2023-11-05",
        "certification_date": "2023-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN170256",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waycross, GA

Sources for this page

Verify at the official NPI Registry.