Individual provider Active NPI

Marie Rosemonde Nozil, MSN, FNP-C

  • Family Nurse Practitioner
  • Gray, GA
National Provider Identifier
1164972188
Registry record updated Oct 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN167209 Issued in GA
Practice address
1005 Boulder Dr
Gray, GA 31032-6141
Phone
(678) 334-7218
NPI assigned
Oct 13, 2016
Last updated
Oct 28, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 28, 2022

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 RN167209 GA Primary

Addresses

Primary practice location

1005 Boulder Dr
Gray, GA 31032-6141

Mailing address

1333 Arbor Bluff CT
Lawrenceville, GA 30045-9775
Phone (678) 334-7218

Other names 1

  • Marie Rosemonde Nozil Professional name

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
I20161205002305 GA Practitioner - Nurse Practitioner 4688954886 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Community Primary Care of Georgia LLCGroup PAC ID 0648421065, 20 clinicians

Practice addresses (Care Compare)

1005 Boulder Dr
Gray, GA 31032-6141
Phone (478) 621-2100

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
50.51 of 100Reported as group
Quality
16.39
Improvement activities
20
Cost
79.97

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
RN167209GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Vision Medical Consulting, P.C. CurrentSince Oct 17, 2016 Accepting new patients
Optimus Diagnostics LLC Current Accepting new patients
Community Primary Care of Georgia LLC CurrentSince May 1, 2022 Accepting new patients

Locations

3715 Northside Pkwy NW
Bldg 200
Atlanta, GA 30327
Phone (770) 938-1757

3715 Northside Pkwy NW
Bldg 2100
Atlanta, GA 30327
Phone (770) 938-1757

54 Peachtree Park Dr NE
Atlanta, GA 30309
Phone (404) 351-6041

1005 Boulder Dr
Gray, GA 31032
Phone (478) 621-2072

1109 Green St
Roswell, GA 30075
Phone (770) 998-1802

Organizations & group practices 3

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1476316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666915200000",
    "number": "1164972188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1333 ARBOR BLUFF CT",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300459775",
            "telephone_number": "678-334-7218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 BOULDER DR",
            "city": "GRAY",
            "state": "GA",
            "postal_code": "310326141",
            "telephone_number": "678-334-7218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOZIL",
        "first_name": "MARIE",
        "middle_name": "ROSEMONDE",
        "name_prefix": "Mrs.",
        "credential": "MSN, FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-10-13",
        "last_updated": "2022-10-28",
        "certification_date": "2022-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN167209",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARIE",
            "last_name": "NOZIL",
            "middle_name": "ROSEMONDE",
            "credential": "MSN, FNP-C",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Gray, GA

Sources for this page

Verify at the official NPI Registry.