Individual provider Active NPI

Linda Merck, PA

  • Physician Assistant
  • Flowery Branch, GA
National Provider Identifier
1376505735
Registry record updated Sep 11, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
591 Issued in GA
Practice address
4331 Thurmond Tanner Rd
Flowery Branch, GA 30542-2829
Phone
(678) 513-5700
Fax
(678) 513-5836
NPI assigned
Apr 3, 2006
Last updated
Sep 11, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 591 GA Primary

Addresses

Primary practice location

4331 Thurmond Tanner Rd
Flowery Branch, GA 30542-2829

Mailing address

4331 Thurmond Tanner Rd
Flowery Branch, GA 30542-2829
Phone (678) 513-5700

Other identifiers 1

IdentifierTypeStateIssuer
GRP2048OtherGAMEDICARE GROUP NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
591GAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Georgia Mountains Community Services Past Accepting new patients

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, 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": "1144022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189468800000",
    "number": "1376505735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4331 THURMOND TANNER RD",
            "city": "FLOWERY BRANCH",
            "state": "GA",
            "postal_code": "305422829",
            "telephone_number": "678-513-5700",
            "fax_number": "678-513-5836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4331 THURMOND TANNER RD",
            "city": "FLOWERY BRANCH",
            "state": "GA",
            "postal_code": "305422829",
            "telephone_number": "678-513-5700",
            "fax_number": "678-513-5836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERCK",
        "first_name": "LINDA",
        "name_prefix": "Ms.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-03",
        "last_updated": "2007-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "591",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER",
            "identifier": "GRP2048",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Flowery Branch, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2007; 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.