Individual provider Active NPI

Michael Kuo

  • Family Nurse Practitioner
  • Tifton, GA
National Provider Identifier
1760922264
Registry record updated Mar 2, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN225408 Issued in GA
Practice address
901 18TH St E
Tifton, GA 31794-3648
Phone
(229) 382-7120
NPI assigned
Mar 2, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2017

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 RN225408 GA Primary

Addresses

Primary practice location

901 18TH St E
Tifton, GA 31794-3648

Mailing address

1709 Gornto Rd
Ste a PMB #183
Valdosta, GA 31601
Phone (229) 548-3377

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
I20170602001278 GA Practitioner - Nurse Practitioner 1658648258 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SGMC Physician Network IncGroup PAC ID 4082036843, 128 clinicians

Practice addresses (Care Compare)

3207 Country Club Rd
Valdosta, GA 31605-1029
Phone (229) 242-8480

Hospital & facility affiliations

  • SGMC Health Hospital, Valdosta, GA, CCN 110122
  • SGMC Health Lanier Hospital, Lakeland, GA, CCN 111326

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
SGMC Physician Network Inc CurrentSince Jun 1, 2022 Accepting new patients
Tift Regional Health System Inc CurrentSince May 3, 2017 Accepting new patients
Tift Regional Health System Inc CurrentSince May 3, 2017 Accepting new patients
SGMC Affiliated Services LLC Current Accepting new patients

Locations

901 18th St E
Tifton, GA 31794
Phone (229) 353-6208

2225 US Highway 41 N
Tifton, GA 31794
Phone (229) 353-3422

2227 US Highway 41 N
Tifton, GA 31794
Phone (229) 353-6188

4280 N Valdosta Rd
Valdosta, GA 31602
Phone (229) 433-7350

2501 N Patterson St
Valdosta, GA 31602
Phone (229) 259-4139

4256 N Valdosta Rd
Valdosta, GA 31602
Phone (229) 242-1234

520 Griffin Ave
Ste A
Valdosta, GA 31601
Phone (229) 433-7340

3207 Country Club Rd
Valdosta, GA 31605
Phone (229) 242-8480

3294 N Oak Street Ext
Ste A
Valdosta, GA 31605
Phone (229) 241-1188

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 and National Provider Directory roles.

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": "1488412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488412800000",
    "number": "1760922264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1709 GORNTO RD",
            "address_2": "STE A PMB #183",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "31601",
            "telephone_number": "229-548-3377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 18TH ST E",
            "city": "TIFTON",
            "state": "GA",
            "postal_code": "317943648",
            "telephone_number": "229-382-7120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUO",
        "first_name": "MICHAEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-02",
        "last_updated": "2017-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN225408",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tifton, GA

Sources for this page

Verify at the official NPI Registry.