Individual provider Active NPI

Meredith Fleenor, NP-C

  • Primary Care Nurse Practitioner
  • Macon, GA
National Provider Identifier
1164995171
Registry record updated Jan 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
RN176796 Issued in GA
Practice address
3356 Vineville Ave
Macon, GA 31204-2328
Phone
(478) 476-9642
NPI assigned
Jan 3, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 3, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X RN176796 GA Primary
Gerontology Nurse Practitioner 363LG0600X RN176796 GA
Adult Health Nurse Practitioner 363LA2200X RN176796 GA

Addresses

Primary practice location

3356 Vineville Ave
Macon, GA 31204-2328

Mailing address

935 Saint Andrews Rd
Macon, GA 31210-7902
Phone (478) 731-3870

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

State licenses

LicenseStateTypeSpecialty
RN176796GAMDPrimary Care Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1546473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546473600000",
    "number": "1164995171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "935 SAINT ANDREWS RD",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312107902",
            "telephone_number": "478-731-3870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3356 VINEVILLE AVE",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312042328",
            "telephone_number": "478-476-9642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLEENOR",
        "first_name": "MEREDITH",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-01-03",
        "last_updated": "2019-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "GA",
            "license": "RN176796",
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "GA",
            "license": "RN176796",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "GA",
            "license": "RN176796",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Macon, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2019; 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.