Henry Santo Intili, FNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

RN123672NP Issued in GA

Practice address

268 Mock Cemetery Rd
Bainbridge, GA 39817-6904

Phone

(800) 841-0858

Fax

(800) 841-0858

NPI assigned

Nov 7, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1851460265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 125",
            "city": "BAINBRIDGE",
            "state": "GA",
            "postal_code": "398180125",
            "telephone_number": "229-246-1428",
            "fax_number": "229-246-1428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "268 MOCK CEMETERY RD",
            "city": "BAINBRIDGE",
            "state": "GA",
            "postal_code": "398176904",
            "telephone_number": "800-841-0858",
            "fax_number": "800-841-0858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INTILI",
        "first_name": "HENRY",
        "middle_name": "SANTO",
        "name_prefix": "Mr.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN123672NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Nurse Practitioner in Bainbridge, GA
• Providers in Bainbridge, GA by specialty
• Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.