Annie Denise Statham, APRN-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN111226 Issued in GA

Practice address

100 Medical Park Way
Americus, GA 31709-3656

Phone

(229) 944-4031

NPI assigned

Jul 10, 2007

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

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, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Phoebe Sumter Medical Center Hospital, Americus, GA, CCN 110044

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/BIJECD/Endpoint/BIJECD
• FHIR API: https://api.platform.athenahealth.com/23479/brand/1/csg/1/fhir/r4

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.

• Trinity Health Clinic LLC

  • Family Nurse Practitioner
  • Americus, GA
  • NPI 1891371134
  Medicare reassignment NPD Authorized official

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Phoebe Sumter Medical Center, Inc.

  • General Acute Care Hospital
  • Americus, GA
  • NPI 1609001312
  Care Compare affiliation

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

{
    "created_epoch": "1184025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624406400000",
    "number": "1982802013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MEDICAL PARK WAY",
            "city": "AMERICUS",
            "state": "GA",
            "postal_code": "317093656",
            "telephone_number": "229-944-4031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MEDICAL PARK WAY",
            "city": "AMERICUS",
            "state": "GA",
            "postal_code": "317093656",
            "telephone_number": "229-944-4031"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "800 Ga. Southwestern State University Drive",
            "address_purpose": "LOCATION",
            "city": "Americus",
            "state": "GA",
            "postal_code": "31709",
            "country_code": "US",
            "telephone_number": "229-931-2235",
            "fax_number": "229-931-2666",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STATHAM",
        "first_name": "ANNIE",
        "middle_name": "DENISE",
        "name_prefix": "Mrs.",
        "credential": "APRN-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-10",
        "last_updated": "2021-06-23",
        "certification_date": "2021-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN111226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Southwest Georgia Rehab, Inc
• Southwest Georgia Surgical Associates, PC
• Cynthia Ann Goodwin Spencer
• Eugenia Cotreace Spivey, M.ED.
• Ke'Mia Starling
• Denise Stephens
• Derrick Stephens
• Eboney Stephens
• Vivian W Stern, M.ED, CCC-SLP
• Angela Anglin Stevens, FNP-C

• Family Nurse Practitioner in Americus, GA
• Providers in Americus, 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 Jun 23, 2021; 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.