Individual provider Active NPI

Mairin Jerome, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Atlanta, GA
National Provider Identifier
1356738983
Registry record updated Jul 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
87501 Issued in GA
Practice address
101 Marietta St NW Ste 3100
Atlanta, GA 30303-2731
Phone
(401) 301-6247
NPI assigned
Apr 21, 2015
Last updated
Jul 31, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 31, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Physical Medicine & Rehabilitation Physician 208100000X 87501 GA Primary
Physical Medicine & Rehabilitation Physician 208100000X 304917-01 NY
Physical Medicine & Rehabilitation Physician 208100000X DR.0062830 CO

Addresses

Primary practice location

101 Marietta St NW Ste 3100
Atlanta, GA 30303-2731

Mailing address

1819 Peachtree Rd NE Ste 250
Atlanta, GA 30309-1857
Phone (770) 852-5551

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230628003425 IA Practitioner - Physical Medicine and RehabilitationPractitioner - Preventive Medicine 1759718505 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
DR.0062830COMDPhysical Medicine & Rehabilitation Physician
87501GAMDPhysical Medicine & Rehabilitation Physician
304917-01NYMDPhysical Medicine & Rehabilitation Physician
304917NYMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
John H Susz DPM, PC Current Accepting new patients
Harbor View Medical Services LLC CurrentSince Apr 30, 2023 Accepting new patients
Centeno-Schultz, Inc Past Accepting new patients
Floyd County Memorial Hospital Commission Past Accepting new patients
Integrative Physical Medicine Physical Medicine & Rehabilitation Past Accepting new patients

Locations

6151 Thornton Ave
Ste 400
Des Moines, IA 50321
Phone (515) 298-7208

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1429574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785456000000",
    "number": "1356738983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1819 PEACHTREE RD NE STE 250",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303091857",
            "telephone_number": "770-852-5551",
            "fax_number": "770-852-8557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 MARIETTA ST NW STE 3100",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303032731",
            "telephone_number": "401-301-6247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEROME",
        "first_name": "MAIRIN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-04-21",
        "last_updated": "2026-07-31",
        "certification_date": "2026-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "GA",
            "license": "87501",
            "primary": true
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NY",
            "license": "304917-01",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CO",
            "license": "DR.0062830",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.