Individual provider Active NPI

Sara S Knox, FNP-C

  • Family Nurse Practitioner
  • Waycross, GA
National Provider Identifier
1760939441
Registry record updated Dec 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN123527 Issued in GA
Practice address
1702 Alice St
Waycross, GA 31501-5216
Phone
(912) 289-5804
Fax
(912) 809-5067
NPI assigned
Sep 9, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 11, 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 RN123527 GA Primary

Addresses

Primary practice location

1702 Alice St
Waycross, GA 31501-5216

Mailing address

1702 Alice St
Waycross, GA 31501-5216
Phone (912) 289-5804

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
I20170510001948 GA Practitioner - Nurse Practitioner 2264719731 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mayo Clinic Health System in Waycross, Inc. CurrentSince Jan 31, 2017 Accepting new patients
Integrated Regional Laboratories Pathology Services, LLC Current Accepting new patients
Mayo Clinic Health System in Waycross, Inc. CurrentSince Jan 31, 2017 Accepting new patients

Locations

316 Shirley Ave
Douglas, GA 31533
Phone (912) 383-0815

1921 Alice St
Ste 4B
Waycross, GA 31501
Phone (912) 285-5690

1206 Alice St
Waycross, GA 31501
Phone (912) 285-1140

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1473379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702252800000",
    "number": "1760939441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1702 ALICE ST",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "315015216",
            "telephone_number": "912-289-5804",
            "fax_number": "912-809-5066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1702 ALICE ST",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "315015216",
            "telephone_number": "912-289-5804",
            "fax_number": "912-809-5067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNOX",
        "first_name": "SARA",
        "middle_name": "S",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-09",
        "last_updated": "2023-12-11",
        "certification_date": "2023-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN123527",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waycross, GA

Sources for this page

Verify at the official NPI Registry.