Individual provider Active NPI

Mariangeli M Hamilton, NP

  • Family Nurse Practitioner
  • Savannah, GA
National Provider Identifier
1801837083
Registry record updated Aug 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN089362 Issued in GA
Practice address
210 E. Derenne Avenue
Savannah, GA 81405
Phone
(912) 644-5300
Fax
(912) 644-5260
NPI assigned
Jun 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X ARNP9243519 FL
Family Nurse Practitioner 363LF0000X RN089362 GA Primary

Addresses

Primary practice location

210 E. Derenne Avenue
Savannah, GA 81405

Mailing address

210 E Derenne Ave
Attn: Hope Villarruel-Sams
Savannah, GA 31405
Phone (912) 644-5300

Other identifiers 3

IdentifierTypeStateIssuer
3078507-00MedicaidFL
513433490HMedicaidGA
513433490AMedicaidGA

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
I20110907001525 GA Practitioner - Nurse Practitioner 7719082734 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ARNP9243519FLMDFamily Nurse Practitioner
RN089362GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Gwinnett Physician Group, LLC CurrentSince Jul 1, 2020 Accepting new patients
Advanced Pediatric Specialists LLC Past Accepting new patients
Georgia Emergency Associates Past Accepting new patients

Locations

3500 McClure Bridge Rd
Duluth, GA 30096
Phone (770) 476-3636

1000 Medical Center Blvd
Lawrenceville, GA 30046
Phone (678) 312-3356

1000 Johnson Fy Rd NE
Sandy Springs, GA 30342
Phone (404) 851-1000

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": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343952000000",
    "number": "1801837083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 E DERENNE AVE",
            "address_2": "ATTN: HOPE VILLARRUEL-SAMS",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "31405",
            "telephone_number": "912-644-5300",
            "fax_number": "912-644-5260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 E. DERENNE AVENUE",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "81405",
            "telephone_number": "912-644-5300",
            "fax_number": "912-644-5260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMILTON",
        "first_name": "MARIANGELI",
        "middle_name": "M",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-09",
        "last_updated": "2012-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP9243519",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN089362",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3078507-00",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "513433490H",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "513433490A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Savannah, GA

Sources for this page

Verify at the official NPI Registry.