Mary Angela Childre

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN125490 Issued in GA

Practice address

134 W Campus Dr
Milledgeville, GA 31061-3639

Phone

(478) 445-5288

NPI assigned

Jul 14, 2016

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Gcsu Athletic Training

  • Athletic Trainer
  • Milledgeville, GA
  • NPI 1033111638
  NPD (past)

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

{
    "created_epoch": "1468454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468454400000",
    "number": "1114370137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 PA JOHNS RD NE",
            "city": "MILLEDGEVILLE",
            "state": "GA",
            "postal_code": "310619070",
            "telephone_number": "478-454-8255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "134 W CAMPUS DR",
            "city": "MILLEDGEVILLE",
            "state": "GA",
            "postal_code": "310613639",
            "telephone_number": "478-445-5288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHILDRE",
        "first_name": "MARY",
        "middle_name": "ANGELA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-14",
        "last_updated": "2016-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN125490",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cherokee Rose Mammography LLC
• Evan Marie Cherone, ATC
• Chigorziri D. Umuna
• Child and Family Guidance of Georgia, Inc
• Landon Childers
• Victoria Jeanine Chin-You
• Sung K Choi, M.D.
• Victor Choice, LPN
• Christopher Bowers MD PC
• Katrina Ransom Clark, PMHNP

• Family Nurse Practitioner in Milledgeville, GA
• Providers in Milledgeville, 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 Jul 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.