MH 102, PC (NPI# 1174157218) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174157218 |
| Entity Type | Organization |
| Organization Name | MH 102, PC |
| Practice Address |
813 E 68th St Ste B Savannah GA 31405-4710 |
| Mailing Address |
Po Box 5 Winooski VT 05404-0005 |
| Practice Telephone | 9122285655 |
| Mailing Telephone | 8028570400 |
| Enumeration Date | 2020-02-27 |
| Last Update Date | 2020-02-27 |
| Authorized Official Name | BEVERLEY RAYMOND (PRESIDENT) |
| Authorized Official Telephone | 8028570400 |
| Authorized Official Credential | NP |
| Is Organization Subpart | Y |
| Parent Organization Name | MH 102, PC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers |
| Other Name | Type Code |
|---|---|
| Chatham County | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285268219 | Mh 102, PC | Nurse Practitioner | 1 Aflac Parkway, Columbus, GA 31907 | 2020-02-28 |
| 1457985590 | Mh 102, PC | Nurse Practitioner | 193 Tilley Dr, South Burlington, VT 05403-4440 | 2020-02-27 |
| 1831723964 | Mh 102, PC | Nurse Practitioner | 1932 Wynnton Rd, Columbus, GA 31999-0001 | 2020-02-27 |
| 1457985509 | Mh 102, PC | Nurse Practitioner | 5204 Bernard Dr Ste 300a, Roanoke, VA 24018-4345 | 2020-02-27 |
| 1588298624 | Mh 102, PC | Nurse Practitioner | 817 Botetourt Ct Ste 106, Chesapeake, VA 23320-4886 | 2020-02-27 |
| 1285105171 | Mh 102, PC | Nurse Practitioner | 2322 Blue Stone Hills Dr Ste 260, Harrisonburg, VA 22801-5403 | 2018-12-17 |
| 1811476286 | Mh 102, PC | Nurse Practitioner | 1020 Barrow Industrial Pkwy, Winder, GA 30680-3891 | 2018-08-07 |
| 1689177040 | Mh 102, PC | Nurse Practitioner | 98 Alexandria Pike Ste 52, Warrenton, VA 20186-2849 | 2018-03-13 |
| 1720599657 | Mh 102, PC | Nurse Practitioner | 864 Spring St Nw, Atlanta, GA 30308-1007 | 2017-10-18 |
| 1053754275 | Mh 102, PC | Non-Pharmacy Dispensing Site | 5650 Main St, C/o Vcs Health Center, Manchester Center, VT 05255-9711 | 2013-04-08 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oklahoma Business Registrations | MH 102, PC | Po Box 5, Winooski, VT 05404 |
| Street Address |
813 E 68TH ST STE B |
| City | SAVANNAH |
| State | GA |
| Zip Code | 31405-4710 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053918441 | Nicole Marie Tetro | Anesthesiology | Candler Hospital, 5353 Reynolds St, Savannah, GA 31405 | 2020-10-08 |
| 1154983880 | Nickes Medical Supply, LLC. | Durable Medical Equipment & Medical Supplies | 6020 Halsey St, Savannah, GA 31405 | 2019-07-02 |
| 1215593025 | Lee Ann Ryle | Nurse Practitioner | 5223 Paulsen St., Savannah, GA 31405 | 2019-05-16 |
| 1942765334 | Raegan Epps | Behavior Technician | 613 Stephenson Ave Ste 205, Savannah, GA 31405 | 2019-02-10 |
| 1679050454 | Phenomenal Nursing Service | Registered Nurse | 604 South St., 604 South St, Savannah, GA 31405 | 2018-07-24 |
| 1275029472 | Chelsea Amanda Keedy | Pharmacist | 836 E. 65th St., Medical Arts #4, Savannah, GA 31405 | 2018-07-11 |
| 1265933840 | Dwc-p LLC | Dentist | 5209 Paulsen Street, Savannah, GA 31405 | 2018-02-28 |
| 1386153005 | Aaron Shaw | Hearing Instrument Specialist | 5501 Abercorn St Ste E, Savannah, GA 31405 | 2017-09-26 |
| 1063946028 | Elizabeth Bentley Bruhn-danello | Dietitian, Registered | 836 East 65th Street, Medical Arts #4, Savannah, GA 31405 | 2017-04-17 |
| 1396278230 | Theresa Lynn George | Health Educator | 836 East 65 Th Street, Medical Arts #4, Savannah, GA 31405 | 2017-04-07 |
| Find all providers in zip 31405 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780216614 | Jennifer Leigh Burroughs | Nurse Practitioner | 2210 E 37th St, Savannah, GA 31404-3843 | 2020-02-08 |
| 1609376359 | Jessica Sierra Letcher | Nurse Practitioner | 4a Skidaway Village Walk, Savannah, GA 31441 | 2018-02-20 |
| 1982006078 | Brittany Frankhouser Smith | Nurse Practitioner | 225 Candler Dr Ste 201, Savannah, GA 31405 | 2014-09-19 |
| 1306112248 | Elizabeth Windom Stewart | Nurse Practitioner | 300 Bull St Ste 102, Savannah, GA 31401 | 2012-03-26 |
| 1457636458 | Ashley Brooke Andrews | Nurse Practitioner | 4750 Waters Ave Ste 108, Savannah, GA 31404-6267 | 2011-10-21 |
| 1366697419 | Jessica Rittie Adkins | Nurse Practitioner | 4849 Paulsen St Ste 312, Savannah, GA 31405 | 2008-11-17 |
| 1780866830 | Teresa D Dailey | Nurse Practitioner | 255 Wayne Rd, Savannah, TN 38372-1947 | 2007-11-30 |
| 1851593594 | Melanie A Reaves Pllc | Nurse Practitioner | 1440 Pickwick St, Savannah, TN 38372 | 2007-06-04 |
| 1710192109 | Jennifer C. Adams | Nurse Practitioner | 4 Jackson Blvd., Savannah, GA 31405 | 2007-05-11 |
| 1235250341 | Laura Nicole Wiggins | Nurse Practitioner | 1674 W Chatham Pkwy, Savannah, GA 31405 | 2007-04-03 |
| Find all providers in SAVANNAH | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.