Individual provider Active NPI

Merrill Depetrillo, NP

  • Nurse Practitioner
  • Jasper, GA
National Provider Identifier
1366458192
Registry record updated Oct 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN108911 Issued in GA
Practice address
1266 Highway 515 S
Jasper, GA 30143-4872
Phone
(706) 692-2441
NPI assigned
Aug 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X RN108911 GA
Nurse Practitioner 363L00000X RN108911 GA Primary

Addresses

Primary practice location

1266 Highway 515 S
Jasper, GA 30143-4872

Mailing address

6010 Riley Rd
Cumming, GA 30028-5927

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
I20231228000332 GA Practitioner - Nurse Practitioner 2567812985 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Piedmont Cardiology of Atlanta, LLCGroup PAC ID 0345321691, 478 clinicians

Practice addresses (Care Compare)

1266 Hwy 515 S
Jasper, GA 30143-4872
Phone (706) 692-2441

Hospital & facility affiliations

  • Piedmont Mountainside Hospital Inc Hospital, Jasper, GA, CCN 110225

Merit-based Incentive Payment System (MIPS)

Final score
91.62 of 100Reported as apm
Quality
83.25
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Piedmont Cardiology of Atlanta, LLC Cardiovascular Disease CurrentSince Nov 18, 2023 Accepting new patients

Locations

101 Riverstone Vis
Ste 101
Blue Ridge, GA 30513
Phone (706) 632-8008

1412 Milstead Ave NE
Conyers, GA 30012
Phone (770) 918-3000

1400 Northside Forsyth Dr
Ste 290
Cumming, GA 30041
Phone (770) 292-3000

1266 Highway 515 S
Jasper, GA 30143
Phone (706) 301-5350

5665 Peachtree Dunwoody Rd
Ste 172
Sandy Springs, GA 30342
Phone (404) 851-5400

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": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759881600000",
    "number": "1366458192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6010 RILEY RD",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300285927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1266 HIGHWAY 515 S",
            "city": "JASPER",
            "state": "GA",
            "postal_code": "301434872",
            "telephone_number": "706-692-2441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEPETRILLO",
        "first_name": "MERRILL",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-01",
        "last_updated": "2025-10-08",
        "certification_date": "2025-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "GA",
            "license": "RN108911",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN108911",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jasper, GA

Sources for this page

Verify at the official NPI Registry.