Individual provider Active NPI

Linda Marie Street, M.D.

  • Maternal & Fetal Medicine Physician
  • Augusta, GA
National Provider Identifier
1962630830
Registry record updated Jan 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Maternal & Fetal Medicine PhysicianTaxonomy code 207VM0101X
License
75544 Issued in GA
Practice address
1120 15TH St
Augusta, GA 30912-0004
Phone
(706) 721-4959
NPI assigned
Jun 30, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2022

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Maternal & Fetal Medicine Physician 207VM0101X 75544 GA Primary
Obstetrics & Gynecology Physician 207V00000X 32026 SC
Obstetrics & Gynecology Physician 207V00000X 75544 GA
Maternal & Fetal Medicine Physician 207VM0101X 32026 SC
Maternal & Fetal Medicine Physician 207VM0101X 2013-00501 NC

Addresses

Primary practice location

1120 15TH St
Augusta, GA 30912-0004

Mailing address

3624 J Dewey Gray Cir Ste 308
Augusta, GA 30909-6580
Phone (706) 922-7670

Other practice location 1

3624 J Dewey Gray Cir Ste 308
Augusta, GA 30909-6580
Phone (706) 922-7670

Other identifiers 3

IdentifierTypeStateIssuer
5632783OtherNCAETNA
179TKOtherNCBCBS
1962630830MedicaidNC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address DHAUGUSTA.COCAG.GAA@CCDA.HCADIRECT.NET

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, KY, TX, IL, SC5 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 5

Enrollment IDStateProvider typePAC IDDetails
I20160726003081 GA Practitioner - Obstetrics/Gynecology 1153579735 Reassigns benefits to 2 organizations
I20190828003518 KY Practitioner - Obstetrics/Gynecology 1153579735 Reassigns benefits to 1 organization
I20190829002959 TX Practitioner - Obstetrics/Gynecology 1153579735 Reassigns benefits to 1 organization
I20191218001450 IL Practitioner - Obstetrics/Gynecology 1153579735 Reassigns benefits to 3 organizations
I20260312003656 SC Practitioner - Obstetrics/Gynecology 1153579735 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carle Health Care IncorporatedGroup PAC ID 3577515774, 1,592 clinicians

Practice addresses (Care Compare)

200 Lerna Rd S
Mattoon, IL 61938-9388
Phone (217) 258-5900

611 W Park St
Urbana, IL 61801-2501
Phone (888) 712-2753

71 Pinner PL
Graniteville, SC 29829-3415
Phone (309) 672-4433

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2013-00501NCMDMaternal & Fetal Medicine Physician
32026SCMDMaternal & Fetal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hoopeston Community Memorial Hospital Current Accepting new patients
Au Medical Associates Inc CurrentSince Aug 1, 2016 Accepting new patients
Alaska Native Tribal Health Consortium CurrentSince Aug 8, 2019 Accepting new patients
University of Louisville Physicians, Inc. CurrentSince Jul 6, 2019 Accepting new patients
Richland Memorial Hospital, Inc Current Accepting new patients
Hoopeston Community Memorial Hospital CurrentSince Dec 9, 2019 Accepting new patients
Hoopeston Community Memorial Hospital Current Accepting new patients
Richland Memorial Hospital, Inc CurrentSince Apr 1, 2020 Accepting new patients
Au Medical Associates Inc CurrentSince Aug 1, 2016 Accepting new patients
University of Louisville Physicians, Inc. Obstetrics & Gynecology Current Accepting new patients
Carle Health Care Incorporated CurrentSince Dec 9, 2019 Accepting new patients
University of Louisville Physicians, Inc. CurrentSince Jul 6, 2019 Accepting new patients

Locations

4315 Diplomacy Dr
Anchorage, AK 99508
Phone (907) 729-1729

4000 Ambassador Dr
Anchorage, AK 99508
Phone (907) 729-1900

4320 Diplomacy Dr
Anchorage, AK 99508
Phone (907) 729-0000

1120 15th St
Augusta, GA 30912
Phone (706) 721-3873

7752 Solution Ctr
Chicago, IL 60677

701 E Orange St
Hoopeston, IL 60942
Phone (217) 283-5531

900 E Scott St
Olney, IL 62450
Phone (618) 345-1000

800 E Locust St
Olney, IL 62450
Phone (618) 395-2131

1201 Ricker Rd
Salem, IL 62881
Phone (618) 548-3194

611 W Park St
Urbana, IL 61801
Phone (217) 383-6941

401 E Chestnut St
Unit 410
Louisville, KY 40202
Phone (502) 271-5999

571 S Floyd St
Louisville, KY 40202
Phone (502) 561-2700

Organizations & group practices 12

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": "1246320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641513600000",
    "number": "1962630830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3624 J DEWEY GRAY CIR STE 308",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309096580",
            "telephone_number": "706-922-7670",
            "fax_number": "706-863-8175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 15TH ST",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309120004",
            "telephone_number": "706-721-4959"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3624 J Dewey Gray Cir Ste 308",
            "address_purpose": "LOCATION",
            "city": "Augusta",
            "state": "GA",
            "postal_code": "309096580",
            "country_code": "US",
            "telephone_number": "706-922-7670",
            "fax_number": "706-863-8175",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STREET",
        "first_name": "LINDA",
        "middle_name": "MARIE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-30",
        "last_updated": "2022-01-07",
        "certification_date": "2020-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VM0101X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": "GA",
            "license": "75544",
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "SC",
            "license": "32026",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "GA",
            "license": "75544",
            "primary": false
        },
        {
            "code": "207VM0101X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": "SC",
            "license": "32026",
            "primary": false
        },
        {
            "code": "207VM0101X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": "NC",
            "license": "2013-00501",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5632783",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "179TK",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1962630830",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "DHAUGUSTA.COCAG.GAA@CCDA.HCADIRECT.NET",
            "affiliation": "N",
            "address_1": "3624 J Dewey Gray Cir Ste 308",
            "city": "Augusta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "309096580",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Augusta, GA

Sources for this page

Verify at the official NPI Registry.