Individual provider Active NPI

Mary Wright, FNP-C

  • Family Nurse Practitioner
  • Cordele, GA
National Provider Identifier
1124479753
Registry record updated Nov 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN198143 Issued in GA
Practice address
1007 E 16TH Ave Ste a
Cordele, GA 31015-4553
Phone
(229) 273-1716
Fax
(229) 273-1720
NPI assigned
Jun 24, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN198143 GA Primary

Addresses

Primary practice location

1007 E 16TH Ave Ste a
Cordele, GA 31015-4553

Mailing address

1007 E 16TH Ave Ste a
Cordele, GA 31015-4553
Phone (229) 273-1716

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20160719002390 GA Practitioner - Nurse Practitioner 3779876362 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN198143GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Family Primecare, LLC CurrentSince Feb 10, 2024 Accepting new patients

Locations

1489 Kennedy Rd
Tifton, GA 31794
Phone (229) 391-9931

Organizations & group practices 2

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": "1466726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730851200000",
    "number": "1124479753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1007 E 16TH AVE STE A",
            "city": "CORDELE",
            "state": "GA",
            "postal_code": "310154553",
            "telephone_number": "229-273-1716",
            "fax_number": "229-273-1720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1007 E 16TH AVE STE A",
            "city": "CORDELE",
            "state": "GA",
            "postal_code": "310154553",
            "telephone_number": "229-273-1716",
            "fax_number": "229-273-1720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WRIGHT",
        "first_name": "MARY",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-24",
        "last_updated": "2024-11-06",
        "certification_date": "2024-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN198143",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cordele, GA

Sources for this page

Verify at the official NPI Registry.