Mary Minter, NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN216867 Issued in GA

Practice address

414 Lugenia Dr
Vidalia, GA 30474-7210

Phone

(912) 537-9355

Fax

(912) 537-7038

NPI assigned

Aug 6, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2015

Medicare assignment

May accept Medicare assignment

Group practices

Brightmoor Hospice LLCGroup PAC ID 7517997141, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Brightmoor Hospice, LLC

  • Community Based Hospice Care Agency
  • Griffin, GA
  • NPI 1275520751
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1438819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438819200000",
    "number": "1275919771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1720 NICOLE LN",
            "city": "VIDALIA",
            "state": "GA",
            "postal_code": "304745640",
            "telephone_number": "404-272-6813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "414 LUGENIA DR",
            "city": "VIDALIA",
            "state": "GA",
            "postal_code": "304747210",
            "telephone_number": "912-537-9355",
            "fax_number": "912-537-7038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINTER",
        "first_name": "MARY",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-06",
        "last_updated": "2015-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN216867",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Middle Georgia DME Company
• Marla Kristen Mikell, FNP-C
• Janice Miller
• Lauren Courtney Miller, M.D.
• Shannon Davy Mimbs, MACMHC, MDIV
• Misty D. Poole, MD, LLC
• Dianne S Mixon, PA-C
• Christine Mobley
• Molly M. Kramer M.D.,P.C.
• Susan J Montford, ARNP, FNP-C

• Family Nurse Practitioner in Vidalia, GA
• Providers in Vidalia, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.