Mary Virginia Brady

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN195811 Issued in GA

Practice address

120 S Zetterower Ave
Statesboro, GA 30458-4816

Phone

(912) 681-7368

Fax

(912) 681-3687

NPI assigned

Oct 14, 2013

Last updated

Dec 16, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bulloch County Board of HealthGroup PAC ID 5193710481, 4 clinicians

Altea Medical Georgia PCGroup PAC ID 2466973516, 3 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• East Georgia Regional Medical Center Hospital, Statesboro, GA, CCN 110075

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/FBFFAA

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.

• Altea Medical Georgia PC

  • Geriatric Medicine (Internal Medicine) Physician
  • Sylvania, GA
  • NPI 1407692452
  Medicare reassignment Care Compare group NPD
• Bulloch County Board of Health

  dba Bulloch Wellness Center

  • Public Health or Welfare Agency
  • Statesboro, GA
  • NPI 1043243876
  Medicare reassignment Care Compare group NPD
• Coffee County Board of Health

  • Public Health or Welfare Agency
  • Douglas, GA
  • NPI 1952346074
  Medicare reassignment NPD
• Toombs County Wellness Center

  • Public Health or Welfare Agency
  • Lyons, GA
  • NPI 1831112879
  Medicare reassignment NPD
• Ware County Board of Health

  • Public Health or Welfare Agency
  • Waycross, GA
  • NPI 1568491785
  Medicare reassignment NPD
• Post Acute Medical PLLC

  • Geriatric Medicine (Internal Medicine) Physician
  • Lanham, MD
  • NPI 1730713025

  GA

  Medicare reassignment NPD
• Provider Partners Care Management LP

  • Nurse Practitioner
  • Columbia, MD
  • NPI 1013348028

  GA

  Medicare reassignment
• Bulloch County Board of Health

  • Public Health or Welfare Agency
  • Statesboro, GA
  • NPI 1417985060
  NPD
• Coffee County Board of Health

  dba Coffee Wellness Center

  • Public Health or Welfare Agency
  • Douglas, GA
  • NPI 1316976699
  NPD
• East Georgia Healthcare Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Reidsville, GA
  • NPI 1093754905
  NPD
• Toombs County Board of Health

  • Public Health or Welfare Agency
  • Lyons, GA
  • NPI 1558390757
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• East Georgia Regional Medical Center, LLC

  • General Acute Care Hospital
  • Statesboro, GA
  • NPI 1265486278
  Care Compare affiliation

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

{
    "created_epoch": "1381708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481846400000",
    "number": "1417385295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 S ZETTEROWER AVE",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304584816",
            "telephone_number": "912-681-7368",
            "fax_number": "912-681-3687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 S ZETTEROWER AVE",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304584816",
            "telephone_number": "912-681-7368",
            "fax_number": "912-681-3687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADY",
        "first_name": "MARY",
        "middle_name": "VIRGINIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-10-14",
        "last_updated": "2016-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN195811",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kyleah Tyana Boyd
• Bria Boyer
• Amanda Roberson Boyles, M.ED., LPC
• Russell Jay Bozeman
• Sarah Braddy
• Allison Bragg, RN
• Carla S. Branch, M.D.
• Morgan Brannen
• Taraya Nicole Bratton
• Kimberly Mi-Suk Brauda, LPC

• Family Nurse Practitioner in Statesboro, GA
• Providers in Statesboro, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.