Individual provider Active NPI

Marcella Marzett, NP

  • Obstetrics & Gynecology Nurse Practitioner
  • Tyrone, GA
National Provider Identifier
1366029381
Registry record updated Mar 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology Nurse PractitionerTaxonomy code 363LX0001X
License
RN228030 Issued in GA
Practice address
190 Handley Rd Ste a
Tyrone, GA 30290-2178
Phone
(770) 997-5714
NPI assigned
Mar 25, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 18, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X RN228030 GA
Obstetrics & Gynecology Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LX0001X RN228030 GA Primary

Addresses

Primary practice location

190 Handley Rd Ste a
Tyrone, GA 30290-2178

Mailing address

390 Thompson CT
Hampton, GA 30228-3496
Phone (404) 932-8599

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
I20211217000759 GA Practitioner - Nurse Practitioner 7517358070 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN228030GAMDObstetrics & Gynecology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
WMC Tyrone LLC Single Specialty CurrentSince Feb 16, 2022 Accepting new patients
Healthchoice Center of Peachtree City LLC Single Specialty CurrentSince Sep 11, 2021 Accepting new patients

Locations

14 Eastbrook Bnd
Ste 201
Peachtree Cty, GA 30269
Phone (770) 408-0184

190 Handley Rd
Tyrone, GA 30290
Phone (678) 904-7053

190 Handley Rd
Ste A
Tyrone, GA 30290
Phone (770) 997-5714

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1616630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647561600000",
    "number": "1366029381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "390 THOMPSON CT",
            "city": "HAMPTON",
            "state": "GA",
            "postal_code": "302283496",
            "telephone_number": "404-932-8599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 HANDLEY RD STE A",
            "city": "TYRONE",
            "state": "GA",
            "postal_code": "302902178",
            "telephone_number": "770-997-5714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARZETT",
        "first_name": "MARCELLA",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-25",
        "last_updated": "2022-03-18",
        "certification_date": "2022-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "GA",
            "license": "RN228030",
            "primary": false
        },
        {
            "code": "363LX0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "GA",
            "license": "RN228030",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyrone, GA

Sources for this page

Verify at the official NPI Registry.