Individual provider Active NPI

Dara Merritt, APRN FNP-C

  • Family Nurse Practitioner
  • Valdosta, GA
National Provider Identifier
1376115998
Registry record updated Jul 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN141655 Issued in GA
Practice address
2804 N Oak St Ste C
Valdosta, GA 31602-5913
Phone
(229) 241-8925
NPI assigned
Jul 13, 2021
Last updated
Jul 13, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN141655 GA Primary

Addresses

Primary practice location

2804 N Oak St Ste C
Valdosta, GA 31602-5913

Mailing address

291C Dunn LN
Moultrie, GA 31788-1797
Phone (229) 921-7800

Other identifiers 2

IdentifierTypeStateIssuer
RN141655OtherLICENSE
161455OtherLICENSE

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
I20210805001096 GA Practitioner - Nurse Practitioner 9931503422 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
May accept Medicare assignment
Group practices
Care Medical Center LLCGroup PAC ID 6406807015, 28 clinicians

Practice addresses (Care Compare)

2804 N Oak St
Suite C
Valdosta, GA 31602-5913
Phone (229) 241-8925

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Care Medical Center LLC CurrentSince Jul 12, 2021 Accepting new patients
Care Medical Center LLC CurrentSince Jul 12, 2021 Accepting new patients

Locations

306 Shirley Ave
Douglas, GA 31533
Phone (229) 241-8925

2804 N Oak St
Ste C
Valdosta, GA 31602
Phone (229) 241-8925

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1626134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626134400000",
    "number": "1376115998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "291C DUNN LN",
            "city": "MOULTRIE",
            "state": "GA",
            "postal_code": "317881797",
            "telephone_number": "229-921-7800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2804 N OAK ST STE C",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316025913",
            "telephone_number": "229-241-8925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERRITT",
        "first_name": "DARA",
        "credential": "APRN FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-13",
        "last_updated": "2021-07-13",
        "certification_date": "2021-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN141655",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "RN141655",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "161455",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Valdosta, GA

Sources for this page

Verify at the official NPI Registry.