Individual provider Active NPI

Mary Catherine Waite

  • Acute Care Nurse Practitioner
  • Newnan, GA
National Provider Identifier
1235782228
Registry record updated Jul 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
RN207217 Issued in GA
Practice address
745 Poplar Rd
Newnan, GA 30265-1618
Phone
(770) 400-1000
NPI assigned
Jul 19, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X RN207217 GA Primary

Addresses

Primary practice location

745 Poplar Rd
Newnan, GA 30265-1618

Mailing address

546 Poplar St Apt 2
Macon, GA 31201-2788
Phone (478) 960-4330

Other practice location 1

1255 Ga-54 W
Fayetteville, GA 30214
Phone (770) 719-7000

Other practice location 2

1968 Peachtree Rd NW
Atlanta, GA 30309-1281
Phone (404) 605-5000

Other practice location 3

1133 Eagles Landing Pkwy
Stockbridge, GA 30281-5085
Phone (678) 604-1000

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
I20191106000568 GA Practitioner - Nurse Practitioner 7719219062 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Piedmont Specialty Hospital Billing LLCGroup PAC ID 4183986490, 252 clinicians

Practice addresses (Care Compare)

1133 Eagles Landing Pkwy
Stockbridge, GA 30281-5085
Phone (678) 604-1000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Piedmont Specialty Hospital Billing LLC CurrentSince Oct 28, 2019 Accepting new patients

Locations

2727 Paces Ferry Rd SE
Ste 1-1100
Atlanta, GA 30339
Phone (470) 271-3421

1968 Ptree Rd NW
Atlanta, GA 30309
Phone (404) 605-2222

1255 Highway 54 W
Fayetteville, GA 30214
Phone (770) 719-6911

745 Poplar Rd
Newnan, GA 30265
Phone (404) 478-8785

1133 Eagles Landing Pkwy
Stockbridge, GA 30281
Phone (678) 604-1000

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.

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": "1563494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563494400000",
    "number": "1235782228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "546 POPLAR ST APT 2",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312012788",
            "telephone_number": "478-960-4330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "745 POPLAR RD",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302651618",
            "telephone_number": "770-400-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1255 GA-54 W",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "GA",
            "postal_code": "30214",
            "country_code": "US",
            "telephone_number": "770-719-7000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1968 Peachtree Rd NW",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303091281",
            "country_code": "US",
            "telephone_number": "404-605-5000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1133 Eagles Landing Pkwy",
            "address_purpose": "LOCATION",
            "city": "Stockbridge",
            "state": "GA",
            "postal_code": "302815085",
            "country_code": "US",
            "telephone_number": "678-604-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WAITE",
        "first_name": "MARY",
        "middle_name": "CATHERINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-19",
        "last_updated": "2019-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "GA",
            "license": "RN207217",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newnan, GA

Sources for this page

Verify at the official NPI Registry.