Individual provider Active NPI

Marguerite Marie Vardman, APRN

  • Adult Health Nurse Practitioner
  • Marietta, GA
National Provider Identifier
1528098639
Registry record updated May 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
076035 Issued in GA
Practice address
625 S Marietta Pkwy SE
Marietta, GA 30060-2748
Phone
(470) 377-7228
Fax
(470) 467-7583
NPI assigned
Jul 4, 2006
Last updated
May 1, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X NPF 14568 CA
Adult Health Nurse Practitioner 363LA2200X 132550 MA
Adult Health Nurse Practitioner 363LA2200X 076035 GA Primary

Addresses

Primary practice location

625 S Marietta Pkwy SE
Marietta, GA 30060-2748

Mailing address

PO Box 740015
Atlanta, GA 30374-0015
Phone (312) 733-9730

Other practice location 1

2122 Manchester Expy
Columbus, GA 31904-6878
Phone (706) 320-2773

Other names 1

  • Marguerite Marie Terlemezian 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
I20070206000021 GA Practitioner - Nurse Practitioner 0042212904 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
304370NYMDHospitalist Physician
NPF 14568CAMDAdult Health Nurse Practitioner
132550MAMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
True North Health Navigation LLC CurrentSince Jan 1, 2022 Accepting new patients
Cogent Healthcare of Georgia PC CurrentSince May 13, 2017 Accepting new patients
True North Health Navigation LLC CurrentSince Jan 1, 2022 Accepting new patients
Acute Care Consultants, Inc Past Accepting new patients

Locations

1 W Court Sq
Ste 750
Decatur, GA 30030
Phone (404) 494-7888

1170 Cleveland Ave
East Point, GA 30344
Phone (404) 305-3500

11 Upper Riverdale Rd SW
Riverdale, GA 30274
Phone (770) 897-7277

5885 Glenridge Dr
Ste 100
Sandy Springs, GA 30328
Phone (678) 321-8546

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, 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": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682899200000",
    "number": "1528098639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 740015",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303740015",
            "telephone_number": "312-733-9730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 S MARIETTA PKWY SE",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300602748",
            "telephone_number": "470-377-7228",
            "fax_number": "470-467-7583"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2122 Manchester Expy",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "GA",
            "postal_code": "319046878",
            "country_code": "US",
            "telephone_number": "706-320-2773",
            "fax_number": "706-596-4226",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VARDMAN",
        "first_name": "MARGUERITE",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-04",
        "last_updated": "2023-05-01",
        "certification_date": "2023-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CA",
            "license": "NPF 14568",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MA",
            "license": "132550",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "GA",
            "license": "076035",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARGUERITE",
            "last_name": "TERLEMEZIAN",
            "middle_name": "MARIE",
            "credential": "APRN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Marietta, GA

Sources for this page

Verify at the official NPI Registry.