Heart of Georgia Primary Care, LLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

HEART OF GEORGIA PRIMARY CARE, LLC

Practice address

911 Plaza Ave Ste C
Eastman, GA 31023-6786

Phone

(478) 374-5774

NPI assigned

Jun 17, 2019

Last updated

Feb 23, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Amy H Cravey, FNP-C

Title

Owner

Phone

(478) 374-5774

Specialties & licenses 2

Addresses

Electronic endpoints 3

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Interoperability endpoints

• Direct secure messaging: amy.cravey@mtpm.eclinicaldirectplus.com
• Direct secure messaging: amy.cravey@mtpmeclinicaldirectplus.com
• FHIR API: https://fhir4.healow.com/fhir/r4/AEADBA

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Amy Harrell Banks, DNP, APRN, FNP-C

  • Nurse Practitioner
  • Eastman, GA
  • NPI 1225362932
  Medicare reassignment Care Compare group NPD
• Brianna Jessup Crummey, NP

  • Family Nurse Practitioner
  • Eastman, GA
  • NPI 1316509771
  Medicare reassignment Care Compare group NPD
• Lucian Clement Moseley, MSN, FNP-C

  • Family Nurse Practitioner
  • Cochran, GA
  • NPI 1902504996
  Medicare reassignment Care Compare group NPD
• Michael Todd Peacock, M.D.

  • Internal Medicine Physician
  • Eastman, GA
  • NPI 1487636742
  Medicare reassignment Care Compare group NPD
• Deananne D Fordham, PAC

  • Medical Physician Assistant
  • Cochran, GA
  • NPI 1215904446
  Medicare reassignment

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

{
    "created_epoch": "1560729600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645574400000",
    "number": "1780244301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "911 PLAZA AVE STE C",
            "city": "EASTMAN",
            "state": "GA",
            "postal_code": "310236786",
            "telephone_number": "478-374-5774",
            "fax_number": "912-374-9112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "911 PLAZA AVE STE C",
            "city": "EASTMAN",
            "state": "GA",
            "postal_code": "310236786",
            "telephone_number": "478-374-5774"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "706 W Barnard St",
            "address_purpose": "LOCATION",
            "city": "Glennville",
            "state": "GA",
            "postal_code": "304273017",
            "country_code": "US",
            "telephone_number": "912-822-1941",
            "fax_number": "912-822-1945",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "150 E Peacock St Ste A",
            "address_purpose": "LOCATION",
            "city": "Cochran",
            "state": "GA",
            "postal_code": "310147847",
            "country_code": "US",
            "telephone_number": "478-271-3200",
            "fax_number": "478-271-3205",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "HEART OF GEORGIA PRIMARY CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-17",
        "last_updated": "2022-02-23",
        "certification_date": "2022-02-23",
        "status": "A",
        "authorized_official_last_name": "CRAVEY",
        "authorized_official_first_name": "AMY",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "478-374-5774",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "FNP-C"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "amy.cravey@mtpm.eclinicaldirectplus.com",
            "affiliation": "N",
            "endpointDescription": "Direct Messaging Address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct Messaging",
            "address_1": "706 W Barnard St",
            "city": "Glennville",
            "state": "GA",
            "country_code": "US",
            "postal_code": "304273017",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "amy.cravey@mtpm.eclinicaldirectplus.com",
            "affiliation": "N",
            "endpointDescription": "Direct Messaging Address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct Messaging",
            "address_1": "911 Plaza Ave Ste C",
            "city": "Eastman",
            "state": "GA",
            "country_code": "US",
            "postal_code": "310236786",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "amy.cravey@mtpmeclinicaldirectplus.com",
            "affiliation": "N",
            "endpointDescription": "Direct Messaging Address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct Messaging",
            "address_1": "150 E Peacock St Ste A",
            "city": "Cochran",
            "state": "GA",
            "country_code": "US",
            "postal_code": "310147847",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Byrd Daniel Harrell, DMD
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• Heart MD
• Heart of Georgia Altamaha Regional Commission
• Heart of Georgia Surgery Associates, LLC
• Heather T Herrington MD LLC
• Heather Tiffany Herrington, M.D.
• Christopher Hightower, NP
• Historic South Inpatient Services

• Family Nurse Practitioner in Eastman, GA
• Providers in Eastman, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.