Active NPI
Mary Popp, RNFA
- Nurse Practitioner
- Decatur, GA
National Provider Identifier
1497827653
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- RN148914
- Practice address
- 332 Kings Hwy
Decatur, GA 30030-5228 - Phone
- (404) 351-0051
- Fax
- (404) 351-0632
- NPI assigned
- Nov 14, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | RN148914 | GA | Primary |
Addresses
Primary practice location
332 Kings Hwy
Decatur, GA 30030-5228
Mailing address
332 Kings Hwy
Decatur, GA 30030-5228
Phone (404) 351-0051
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN148914 | GA | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163462400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1497827653",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "332 KINGS HWY",
"city": "DECATUR",
"state": "GA",
"postal_code": "300305228",
"telephone_number": "404-351-0051",
"fax_number": "404-351-0632"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "332 KINGS HWY",
"city": "DECATUR",
"state": "GA",
"postal_code": "300305228",
"telephone_number": "404-351-0051",
"fax_number": "404-351-0632"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POPP",
"first_name": "MARY",
"credential": "RNFA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-11-14",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "GA",
"license": "RN148914",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Decatur, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.