Individual provider Active NPI

Rachel Russell Meadors, CRNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Thomasville, GA
National Provider Identifier
1811333784
Registry record updated Apr 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
RN286724 Issued in GA
Practice address
100 S Madison St
Thomasville, GA 31792-5473
Phone
(229) 221-9552
NPI assigned
May 17, 2013
Last updated
Apr 29, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X RN286724 GA Primary

Addresses

Primary practice location

100 S Madison St
Thomasville, GA 31792-5473

Mailing address

1100 7TH Ave
Jasper, AL 35501

Other identifiers 1

IdentifierTypeStateIssuer
RN286724OtherGAMEDICAL 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
I20200406003417 GA Practitioner - Nurse Practitioner 1052546074 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Alabama School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SGMP Southland, LLCGroup PAC ID 1153563770, 28 clinicians

Practice addresses (Care Compare)

2927 Demere Rd
St Simons Is, GA 31522-1620
Phone (229) 236-0831

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
RN286724GAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
SGMP Southland LLC CurrentSince Aug 1, 2019 Accepting new patients
Choice Family Medicine, PC Current Accepting new patients
Allergy Associates, Inc Past Accepting new patients

Locations

116 W Thigpen Ave
Ste D
Lakeland, GA 31635
Phone (229) 482-8585

2927 Demere Rd
St Simons Island, GA 31522
Phone (912) 638-1999

100 S Madison St
Thomasville, GA 31792
Phone (229) 221-9552

201 Woodrow Wilson Dr
Valdosta, GA 31602
Phone (229) 241-0041

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, 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": "1368748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588118400000",
    "number": "1811333784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 7TH AVE",
            "city": "JASPER",
            "state": "AL",
            "postal_code": "35501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 S MADISON ST",
            "city": "THOMASVILLE",
            "state": "GA",
            "postal_code": "317925473",
            "telephone_number": "229-221-9552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEADORS",
        "first_name": "RACHEL",
        "middle_name": "RUSSELL",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-17",
        "last_updated": "2020-04-29",
        "certification_date": "2020-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "GA",
            "license": "RN286724",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "RN286724",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Thomasville, GA

Sources for this page

Verify at the official NPI Registry.