NPIMap

Organization Active NPI

Northeast Georgia Medical Center

  • Acute Care Nurse Practitioner
  • Anderson, SC
National Provider Identifier
1326392689
Registry record updated Mar 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
RN205146 Issued in GA
Legal business name
NORTHEAST GEORGIA MEDICAL CENTER
Practice address
115 Melia LN
Anderson, SC 29625-6361
Phone
(864) 314-9526
NPI assigned
Nov 7, 2012
Last updated
Mar 14, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2013

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

Authorized official

Name
Mrs. Mary Elizabeth Fairchilds, ACNP-BC
Title
Mid Level Provider
Phone
(864) 314-9526

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X RN205146 GA Primary

Addresses

Primary practice location

115 Melia LN
Anderson, SC 29625-6361

Mailing address

115 Melia LN
Anderson, SC 29625-6361
Phone (864) 314-9526

National Provider Directory

National Provider Directory
Tax ID family
Northeast Ga Med Center11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1352246400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1363219200000",
    "number": "1326392689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 MELIA LN",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "296256361",
            "telephone_number": "864-314-9526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 MELIA LN",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "296256361",
            "telephone_number": "864-314-9526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST GEORGIA MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-07",
        "last_updated": "2013-03-14",
        "status": "A",
        "authorized_official_last_name": "FAIRCHILDS",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "ELIZABETH",
        "authorized_official_title_or_position": "MID LEVEL PROVIDER",
        "authorized_official_telephone_number": "864-314-9526",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "ACNP-BC"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "GA",
            "license": "RN205146",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anderson, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2013; 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.