Individual provider Active NPI

Mary Katherine Rockwell, NP-C

  • Nurse Practitioner
  • Savannah, GA
National Provider Identifier
1780951301
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN080582 Issued in GA
Practice address
225 Candler Dr
Savannah, GA 31405-6023
Phone
(912) 354-6187
NPI assigned
Nov 28, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN080582 GA Primary

Addresses

Primary practice location

225 Candler Dr
Savannah, GA 31405-6023

Mailing address

5400 Sutlive St
Savannah, GA 31405-4721
Phone (912) 354-6187

Other practice location 1

8 Okatie Center Blvd S
Okatie, SC 29909-7532
Phone (843) 705-4848

Other practice location 2

459 Highway 119 S Ste B
Springfield, GA 31329-3021
Phone (912) 354-6187

Other practice location 3

4700 Waters Ave
Savannah, GA 31404-6220
Phone (912) 354-6187

Other practice location 4

16741 Highway 67 Ste B
Statesboro, GA 30458-2529
Phone (912) 354-6187

Other identifiers 2

IdentifierTypeStateIssuer
003149225DMedicaidGA
RN080582OtherGASTATE LICENSE

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
I20120327000824 GA Practitioner - Nurse Practitioner 2163682246 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

225 Candler Dr
Suite 300
Savannah, GA 31405-6091
Phone (912) 354-6187

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
69.81 of 100Reported as group
Quality
58.86
Promoting interoperability
53
Improvement activities
40
Cost
70.07

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN080582GAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Candler Medical Oncology Practice, LLC CurrentSince Dec 1, 2014 Accepting new patients
Effingham Physician Practices, LLC CurrentSince Sep 1, 2016 Accepting new patients
Candler Medical Oncology Practice, LLC CurrentSince Dec 1, 2014 Accepting new patients

Locations

5400 Sutlive St
Savannah, GA 31405
Phone (912) 201-3825

4700 Waters Ave
Savannah, GA 31404
Phone (912) 273-1100

225 Candler Dr
Ste 300
Savannah, GA 31405

225 Candler Dr
Savannah, GA 31405
Phone (912) 819-8571

459 Highway 119 S
Ste B
Springfield, GA 31329
Phone (912) 754-2560

459 Highway 119 S
Springfield, GA 31329
Phone (912) 754-0200

1497 Fair Rd
Ste 305
Statesboro, GA 30458
Phone (912) 871-1360

16741 Highway 67
Ste B
Statesboro, GA 30458

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8042/brand/1/csg/1/fhir/r4
  • FHIR API: https://fhir-usa.unify.chbase.com/org/candler-47b034e8
  • Direct secure messaging: krockwell@summitcancercare.direct.varian.com

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.

Hospital & facility affiliations 1

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": "1322438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1780951301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5400 SUTLIVE ST",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314054721",
            "telephone_number": "912-354-6187",
            "fax_number": "912-355-9807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 CANDLER DR",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314056023",
            "telephone_number": "912-354-6187"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8 Okatie Center Blvd S",
            "address_purpose": "LOCATION",
            "city": "Okatie",
            "state": "SC",
            "postal_code": "299097532",
            "country_code": "US",
            "telephone_number": "843-705-4848",
            "fax_number": "912-354-9807",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "459 Highway 119 S Ste B",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "GA",
            "postal_code": "313293021",
            "country_code": "US",
            "telephone_number": "912-354-6187",
            "fax_number": "912-355-9807",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4700 Waters Ave",
            "address_purpose": "LOCATION",
            "city": "Savannah",
            "state": "GA",
            "postal_code": "314046220",
            "country_code": "US",
            "telephone_number": "912-354-6187",
            "fax_number": "912-355-9807",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "16741 Highway 67 Ste B",
            "address_purpose": "LOCATION",
            "city": "Statesboro",
            "state": "GA",
            "postal_code": "304582529",
            "country_code": "US",
            "telephone_number": "912-354-6187",
            "fax_number": "912-355-9807",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROCKWELL",
        "first_name": "MARY",
        "middle_name": "KATHERINE",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-28",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN080582",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003149225D",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "RN080582",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Savannah, GA

Sources for this page

Verify at the official NPI Registry.