MARY JANE HAMMACK (NPI# 1265615959) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265615959 |
| Entity Type | Individual |
| Full Name | MARY JANE HAMMACK |
| Credential | NP |
| Practice Address |
4700 Waters Ave Savannah GA 31404-6220 |
| Practice Telephone | 9123501316 |
| Practice Fax Number | 9123502156 |
| Mailing Telephone | 9123501316 |
| Mailing Fax Number | 9123502156 |
| Enumeration Date | 2007-12-17 |
| Last Update Date | 2014-07-02 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363L00000X | Nurse Practitioner | 5387P | KY | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
RN166815 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 003145582A | 05 | |
| SC | NP2728 | 05 | |
| GA | RAILROAD MEDICARE | P01312094 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417434416 | Mary E Hammack | Registered Nurse | 2770 Arapahoe Rd Ste 132-221, Lafayette, CO 80026-8018 | 2018-07-23 |
| 1871501874 | Mary M Hammack | Internal Medicine | 6124 W Parker Rd, Mob IIi Suite 234, Plano, TX 75093-8124 | 2006-08-04 |
| Street Address |
4700 WATERS AVE |
| City | SAVANNAH |
| State | GA |
| Zip Code | 31404-6220 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023012010 | Peter M Britt | Radiology | 4700 Waters Ave, Savannah, GA 31404-6220 | 2005-06-08 |
| 1255938288 | Mckenna Maria Valencia | Anesthesiologist Assistant | 4700 Waters Ave, Savannah, GA 31404-6220 | 2020-10-02 |
| 1184239451 | Avery Thomas Helms | Anesthesiologist Assistant | 4700 Waters Ave, Savannah, GA 31404-6220 | 2020-09-13 |
| 1619580800 | Matthew Shannon | Anesthesiologist Assistant | 4700 Waters Ave, Savannah, GA 31404-6220 | 2020-08-26 |
| 1679184840 | Anna Tincher | Anesthesiologist Assistant | 4700 Waters Ave, Savannah, GA 31404-6220 | 2020-08-12 |
| 1669083168 | Christie Vernon Klinginsmith | Anesthesiologist Assistant | 4700 Waters Ave, Savannah, GA 31404-6220 | 2020-08-10 |
| 1396355004 | Noah Radjenovic | Anesthesiologist Assistant | 4700 Waters Ave, Savannah, GA 31404-6220 | 2020-08-06 |
| 1558987115 | Alyssa Nadji | Registered Nurse | 4700 Waters Ave, Savannah, GA 31404-6220 | 2020-06-19 |
| 1952926065 | Mary Helen Ondriezek | Registered Nurse | 4700 Waters Ave, Savannah, GA 31404-6220 | 2020-06-15 |
| 1326661463 | Danielle Marie Carroll | Pharmacist | 4700 Waters Ave, Savannah, GA 31404-6220 | 2020-05-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043864580 | Carli A Boatright | Registered Nurse | 4750 Waters Ave Suite 206, Savannah, GA 31404 | 2019-08-01 |
| 1619530573 | Morgan Johnson | Student in an Organized Health Care Education/Training Program | Memorial Health University Medical Center, 4700 Waters Ave, Savannah, GA 31404 | 2019-04-17 |
| 1477050243 | Kevin Timperman | Student in an Organized Health Care Education/Training Program | 4700 Waters Avenus, Surgery Residency Program, Mhumc, Savannah, GA 31404 | 2018-04-09 |
| 1376048959 | Nina Jo Paletta | Student in an Organized Health Care Education/Training Program | Memorial University Medical Center, 4700 Waters Ave., Savannah, GA 31404 | 2018-03-27 |
| 1972036200 | Jose Adrian Lara Gonzalez | Student in an Organized Health Care Education/Training Program | 4700 Waters Ave, Memorial University Medical Center, Internal Medicine Residency Program, Savannah, GA 31404 | 2017-04-04 |
| 1407210396 | Lexie Hester Vaughn | Student in an Organized Health Care Education/Training Program | 1250 East 66th St, Savannah, GA 31404 | 2016-04-07 |
| 1336503291 | Miles Love | Student in an Organized Health Care Education/Training Program | 1250 East 66th Street, Savannah, GA 31404 | 2016-04-07 |
| 1134536881 | David Patch | Specialist/Technologist | Pediatric Residency Program, Memorial University, Medical Center 4700 Waters Avenue, Savannah, GA 31404 | 2014-07-15 |
| 1962846683 | Alan Danilo Zevallos | Internal Medicine | 4700 Waters Avenue, University Medical Center, Internal Medicine Residency Program, Memorial Health, Savannah, GA 31404 | 2013-04-24 |
| 1730446394 | Joshua Ryan Fann | Prosthetist | 3840 Waters Ave, Savannah, GA 31404 | 2012-04-19 |
| Find all providers in zip 31404 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093316820 | Odyne Rose Lacossiere-dorvilus | Nurse Practitioner | 30 Myrtlewood Dr, Savannah, GA 31405-1024 | 2020-11-06 |
| 1952900383 | Micaiah Mitchell | Nurse Practitioner | 10612 Middleground Rd Apt 513, Savannah, GA 31419-1268 | 2020-10-17 |
| 1104424712 | Yolanda Michelle Miller | Nurse Practitioner | 1651 Mckinnon Dr, Savannah, GA 31404-2319 | 2020-10-15 |
| 1730795386 | Shanika Graham | Nurse Practitioner | 2330 Coakley St, Savannah, GA 31404-4947 | 2020-09-18 |
| 1508479775 | Tonya L Creasy | Nurse Practitioner | 170 Barker Dr, Savannah, TN 38372-8419 | 2020-08-28 |
| 1356952394 | Elizabeth Woods Hammond | Nurse Practitioner | 107 W Liberty St Apt 6, Savannah, GA 31401-3965 | 2020-08-13 |
| 1740898915 | Bryan S Christain | Nurse Practitioner | 340 Hodgson Ct Ste 2, Savannah, GA 31406-1523 | 2020-07-14 |
| 1841814753 | Billie Sweeney | Nurse Practitioner | 134 Horse Creek Rd, Savannah, TN 38372-2984 | 2020-06-05 |
| 1609401140 | Malika Anderson Batie | Nurse Practitioner | 1632 Cloverdale Dr, Savannah, GA 31415-7814 | 2020-03-05 |
| 1760017206 | Evelia Johnsen | Nurse Practitioner | 11702 Mercy Blvd Ste 2g, Savannah, GA 31419-1777 | 2020-03-05 |
| 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.