Individual provider Active NPI

Cheryl Jean Ard, ANP-BC

  • Adult Health Nurse Practitioner
  • Statesboro, GA
National Provider Identifier
1780938647
Registry record updated Oct 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
RN070092 Issued in GA
Practice address
412 Northside Dr E
Statesboro, GA 30458-4802
Phone
(912) 764-9684
NPI assigned
Oct 30, 2012
Last updated
Oct 30, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X RN070092 GA Primary

Addresses

Primary practice location

412 Northside Dr E
Statesboro, GA 30458-4802

Mailing address

111 Hazelwood Dr
Statesboro, GA 30458-9141
Phone (912) 690-4302

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
I20150612000705 GA Practitioner - Nurse Practitioner 6406167717 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gray Family Health LLCGroup PAC ID 0244318111, 6 clinicians

Practice addresses (Care Compare)

260 W Clinton St
Gray, GA 31032-5430
Phone (478) 986-4743

260 W Clinton St
Gray, GA 31032-5464

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Gray Family Health LLC CurrentSince May 18, 2015 Accepting new patients

Locations

260 W Clinton St
Gray, GA 31032
Phone (478) 845-7462

Organizations & group practices 1

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": "1351555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351555200000",
    "number": "1780938647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 HAZELWOOD DR",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304589141",
            "telephone_number": "912-690-4302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "412 NORTHSIDE DR E",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304584802",
            "telephone_number": "912-764-9684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARD",
        "first_name": "CHERYL",
        "middle_name": "JEAN",
        "name_prefix": "Mrs.",
        "credential": "ANP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-30",
        "last_updated": "2012-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "GA",
            "license": "RN070092",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Statesboro, GA

Sources for this page

Verify at the official NPI Registry.