Individual provider Active NPI

Mary C Siror, NP

  • Nurse Practitioner
  • Macon, GA
National Provider Identifier
1508379090
Registry record updated Oct 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN160662 Issued in GA
Practice address
308 Coliseum Dr Ste 120
Macon, GA 31217-3859
Phone
(478) 745-6130
Fax
(478) 745-4443
NPI assigned
Nov 7, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN160662 GA Primary
Family Nurse Practitioner 363LF0000X RN160662 GA

Addresses

Primary practice location

308 Coliseum Dr Ste 120
Macon, GA 31217-3859

Mailing address

308 Coliseum Dr
Macon, GA 31217-3865
Phone (478) 745-6130

Other identifiers 2

IdentifierTypeStateIssuer
G20164AOtherGAMEDICARE PTAN
003232245AMedicaidGA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mary.sirornpc.p1@direct.gacancer.nextgenshare.com Direct

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
I20200430002811 GA Practitioner - Nurse Practitioner 5496185654 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

308 Coliseum Dr
Suite 120
Macon, GA 31217-3859
Phone (478) 745-6130

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
71.19 of 100Reported as group
Quality
69.24
Improvement activities
40
Cost
51.37

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
NSH Cancer Institute Professional Services G, LLC CurrentSince May 11, 2020 Accepting new patients
NSH Cancer Institute Professional Services G, LLC Current Accepting new patients
NSH Cancer Institute Professional Services G LLC CurrentSince May 11, 2020 Accepting new patients
Northside Imaging LLC Past Accepting new patients

Locations

1835 Savoy Dr
Ste 300
Atlanta, GA 30341
Phone (678) 288-9555

308 Coliseum Dr
Ste 120
Macon, GA 31217
Phone (478) 745-6130

1045 Southcrest Dr
Ste 200
Stockbridge, GA 30281
Phone (678) 289-0549

Interoperability endpoints

  • Direct secure messaging: mary.sirornpc.p1@direct.gacancer.nextgenshare.com

Organizations & group practices 4

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 3

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": "1510012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760313600000",
    "number": "1508379090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "308 COLISEUM DR",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312173865",
            "telephone_number": "478-745-6130",
            "fax_number": "478-745-4443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "308 COLISEUM DR STE 120",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312173859",
            "telephone_number": "478-745-6130",
            "fax_number": "478-745-4443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIROR",
        "first_name": "MARY",
        "middle_name": "C",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-07",
        "last_updated": "2025-10-13",
        "certification_date": "2025-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN160662",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN160662",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "G20164A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003232245A",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mary.sirornpc.p1@direct.gacancer.nextgenshare.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct Edge",
            "address_1": "308 Coliseum Dr Ste 120",
            "city": "Macon",
            "state": "GA",
            "country_code": "US",
            "postal_code": "312173859",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Macon, GA

Sources for this page

Verify at the official NPI Registry.