Porsche Tiasha Orange-Johnson, FAMILY NURSE PRACTIT

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN260788 Issued in GA

Practice address

2108 Screven Ave
Waycross, GA 31501-6047

Phone

(912) 816-3206

NPI assigned

Sep 26, 2022

Last updated

Sep 26, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Acs Primary Care Physicians - Southeast PCGroup PAC ID 5193620714, 409 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Acs Primary Care Physicians - Southeast PC

  • Emergency Medicine Physician
  • Myrtle Beach, SC
  • NPI 1861430555

  GA

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1664150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664150400000",
    "number": "1982327730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2108 SCREVEN AVE",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "315016047",
            "telephone_number": "912-816-3206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2108 SCREVEN AVE",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "315016047",
            "telephone_number": "912-816-3206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ORANGE-JOHNSON",
        "first_name": "PORSCHE",
        "middle_name": "TIASHA",
        "name_prefix": "Mrs.",
        "credential": "FAMILY NURSE PRACTIT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-26",
        "last_updated": "2022-09-26",
        "certification_date": "2022-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN260788",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RN260788",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FAMILY NURSE PRACTITIONER",
            "identifier": "RN260788",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Oncology Hematology Care Center, Inc
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• One Source Vascular
• Optimal Readings Professional Services, LLC
• Options Care & Services
• Orthopaedic Specialists of South Georgia
• Orthopedic Center PC (Optim Orthopedics)
• Orthopedic Surgeons of Georgia LLC (Optim Orthopedics)
• Orthopedics Surgeons of Georgia, LLC (Optim Orthopedics - Waycross)
• Regina Osime, LCSW

• Family Nurse Practitioner in Waycross, GA
• Providers in Waycross, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.