Mary Kelly Harbin, NP-C

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

RN155084 Issued in GA

Practice address

1825 Martha Berry Blvd NW
Rome, GA 30165-1625

Phone

(706) 238-8012

Fax

(706) 238-8013

NPI assigned

Jun 12, 2008

Last updated

Aug 20, 2019By 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 1

Other names 1

• Mary Kelly Carter Other name

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

Group practices

Clocktower Medical Group, LLCGroup PAC ID 4082152772, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Adventhealth Redmond Hospital, Rome, GA, CCN 110168

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/FEIFDD/Endpoint/FEIFDD

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.

• Clocktower Medical Group, LLC

  • Family Medicine Physician
  • Rome, GA
  • NPI 1427895200
  Medicare reassignment Care Compare group NPD
• Harbin Clinic, LLC

  dba Harbin Clinic

  • Multi-Specialty Clinic/Center
  • Rome, GA
  • NPI 1679599088
  NPD
• Harbin Clinic, LLC

  • Ambulatory Surgical Clinic/Center
  • Cartersville, GA
  • NPI 1467016055
  NPD (past)

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

• Redmond Park Hospital, LLC

  dba Adventhealth Redmond

  • General Acute Care Hospital
  • Rome, GA
  • NPI 1508810565
  Care Compare affiliation

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

{
    "created_epoch": "1213228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566259200000",
    "number": "1083874119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 RIVERBEND DR SW",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301616005",
            "telephone_number": "706-295-5331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1825 MARTHA BERRY BLVD NW",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301651625",
            "telephone_number": "706-238-8012",
            "fax_number": "706-238-8013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARBIN",
        "first_name": "MARY",
        "middle_name": "KELLY",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-12",
        "last_updated": "2019-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN155084",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003105007A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "CARTER",
            "middle_name": "KELLY",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Harbin Clinic, LLC (Harbin Clinic)
• Harbin Clinic, LLC (Harbin Clinic Dialysis Center)
• Bannester Lester Harbin Jr., MD
• Buford Goodwin Harbin, MD
• Frank Rockwell Harbin, PHD
• Robert Lester Harbin, MD
• William P Harbin II
• Harborview Rome, LLC (Harborview Rome)
• Brian Corey Hard, MD
• Melissa Anne Hardison, NP-C

• Nurse Practitioner in Rome, GA
• Providers in Rome, GA by specialty
• Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2019; 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.