Individual provider Active NPI

Susan J Montford, ARNP, FNP-C

  • Nurse Practitioner
  • Vidalia, GA
National Provider Identifier
1750914925
Registry record updated Apr 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN146160 Issued in GA
Practice address
3193 E 1St St
Vidalia, GA 30474-8830
Phone
(912) 537-8588
NPI assigned
Feb 17, 2020
Last updated
Apr 4, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN146160 GA Primary
Family Nurse Practitioner 363LF0000X RN149160 GA

Addresses

Primary practice location

3193 E 1St St
Vidalia, GA 30474-8830

Mailing address

700 Mitchell Dr
Vidalia, GA 30474-9319
Phone (912) 423-1323

Other practice location 1

1 Meadows Pkwy
Vidalia, GA 30474-8759
Phone (912) 535-5555

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL CAQH Direct

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
I20200521002826 GA Practitioner - Nurse Practitioner 3476974783 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Peachtree Immediate Care FP, LLCGroup PAC ID 3274559323, 328 clinicians

Practice addresses (Care Compare)

3193 E 1St St
Vidalia, GA 30474-8830
Phone (912) 537-8588

Merit-based Incentive Payment System (MIPS)

Final score
94.51 of 100Reported as apm
Quality
80.61
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN146160GAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Peachtree Immediate Care FP, LLC CurrentSince Sep 18, 2024 Accepting new patients
Montgomery Emergency Group, LLC Nurse Practitioner CurrentSince Sep 30, 2024 Accepting new patients
Applecare Memorial Immediate Care Joint Venture LLC CurrentSince Apr 7, 2025 Accepting new patients
Accordia Healthcare LLC CurrentSince Feb 13, 2020 Accepting new patients

Locations

590 Lanier Ave W
Fayetteville, GA 30214

3827 Jimmy Lee Smith Pkwy
Hiram, GA 30141
Phone (770) 222-8900

14089 Abercorn St
Savannah, GA 31419
Phone (912) 349-4945

1 Meadows Pkwy
Vidalia, GA 30474
Phone (912) 535-5429

3193 E 1st St
Vidalia, GA 30474
Phone (912) 537-8588

1205 Russell Pkwy
Warner Robins, GA 31088
Phone (478) 302-5729

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

Organizations & group practices 4

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": "1581897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743724800000",
    "number": "1750914925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 MITCHELL DR",
            "city": "VIDALIA",
            "state": "GA",
            "postal_code": "304749319",
            "telephone_number": "912-423-1323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3193 E 1ST ST",
            "city": "VIDALIA",
            "state": "GA",
            "postal_code": "304748830",
            "telephone_number": "912-537-8588"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Meadows Pkwy",
            "address_purpose": "LOCATION",
            "city": "Vidalia",
            "state": "GA",
            "postal_code": "304748759",
            "country_code": "US",
            "telephone_number": "912-535-5555",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MONTFORD",
        "first_name": "SUSAN",
        "middle_name": "J",
        "credential": "ARNP, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-17",
        "last_updated": "2025-04-04",
        "certification_date": "2025-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN146160",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN149160",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "CAQH",
            "affiliation": "N",
            "endpointDescription": "CAQH ProView is an online provider data-collection solution",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "Accordia Urgent Care & Family Practice",
            "address_2": "3193 E 1st St",
            "city": "VIDALIA",
            "state": "GA",
            "country_code": "US",
            "postal_code": "304743047",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Vidalia, GA

Sources for this page

Verify at the official NPI Registry.