Individual provider Active NPI

Marjorie Parker, NP

  • Nurse Practitioner
  • Douglasville, GA
National Provider Identifier
1457060196
Registry record updated Apr 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
254813 Issued in GA
Practice address
8901 Stonebridge Blvd Ste 200
Douglasville, GA 30134-2254
Phone
(943) 202-7120
Fax
(470) 986-7087
NPI assigned
Nov 21, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 26, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 254813 GA Primary

Addresses

Primary practice location

8901 Stonebridge Blvd Ste 200
Douglasville, GA 30134-2254

Mailing address

8901 Stonebridge Blvd
Douglasville, GA 30134-2244
Phone (943) 202-7120

Other names 1

  • Marjorie Vanden-Bossche Former name

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
I20230615000198 GA Practitioner - Nurse Practitioner 9436517935 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellstar Medical Group LLCGroup PAC ID 6709065402, 3,059 clinicians

Practice addresses (Care Compare)

148 Bill Carruth Pkwy
Hiram, GA 30141-3756

5150 Stilesboro N W Rd
Suite 220
Kennesaw, GA 30152-7742
Phone (770) 424-8222

8901 Stonebridge Blvd
Suite 200
Douglasville, GA 30134-2254
Phone (943) 202-7120

8954 Hospital Dr
Douglasville, GA 30134-2272
Phone (678) 838-2585

Hospital & facility affiliations

  • Wellstar Douglas Medical Center Hospital, Douglasville, GA, CCN 110184

Merit-based Incentive Payment System (MIPS)

Final score
93.93 of 100Reported as apm
Quality
82.14
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
254813GAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wellstar Medical Group, LLC CurrentSince May 1, 2023 Accepting new patients
Wellstar Medical Group, LLC Current Accepting new patients
Wellstar Cardiovascular Medicine, LLC PastSince Apr 28, 2024 Accepting new patients

Locations

3950 Austell Rd
Austell, GA 30106
Phone (770) 732-3752

8901 Stonebridge Blvd
Ste 200
Douglasville, GA 30134
Phone (943) 202-7030

8954 Hospital Dr
Douglasville, GA 30134
Phone (678) 838-2584

2518 Jimmy Lee Smith Pkwy
Hiram, GA 30141
Phone (470) 644-7000

5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222

677 Church St NE
Marietta, GA 30060
Phone (770) 793-5435

Organizations & group practices 3

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": "1668988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714089600000",
    "number": "1457060196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8901 STONEBRIDGE BLVD",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301342244",
            "telephone_number": "943-202-7120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8901 STONEBRIDGE BLVD STE 200",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301342254",
            "telephone_number": "943-202-7120",
            "fax_number": "470-986-7087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARKER",
        "first_name": "MARJORIE",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-11-21",
        "last_updated": "2024-04-26",
        "certification_date": "2024-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "254813",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARJORIE",
            "last_name": "VANDEN-BOSSCHE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Douglasville, GA

Sources for this page

Verify at the official NPI Registry.