Individual provider Active NPI

Mary Elizabeth Cahill, CPNP

  • Pediatric Nurse Practitioner
  • Marietta, GA
National Provider Identifier
1114901337
Registry record updated Jun 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
RN083997 Issued in GA
Practice address
777 Franklin Rd SE
Marietta, GA 30067-7803
Phone
(770) 732-6007
Fax
(770) 732-8242
NPI assigned
Dec 1, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X RN083997 GA Primary

Addresses

Primary practice location

777 Franklin Rd SE
Marietta, GA 30067-7803

Mailing address

777 Franklin Rd SE
Marietta, GA 30067-7803
Phone (770) 732-6007

Other identifiers 1

IdentifierTypeStateIssuer
000813425DMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Certified Pediatric Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN083997GAMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Nuestros Ninos Our Kids Pediatrics Inc. Pediatrics Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: mary.cahill@gadirect.net

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1133395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339372800000",
    "number": "1114901337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 FRANKLIN RD SE",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300677803",
            "telephone_number": "770-732-6007",
            "fax_number": "770-732-8242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 FRANKLIN RD SE",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300677803",
            "telephone_number": "770-732-6007",
            "fax_number": "770-732-8242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAHILL",
        "first_name": "MARY",
        "middle_name": "ELIZABETH",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-01",
        "last_updated": "2012-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "GA",
            "license": "RN083997",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000813425D",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2012; 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.