Individual provider Active NPI

Mary J Charlot, FNP-C

  • Family Nurse Practitioner
  • Douglasville, GA
National Provider Identifier
1578802286
Registry record updated Apr 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
187056 Issued in GA
Practice address
2022 Highway 92 Fairburn Rd Ste F
Douglasville, GA 30135-1062
Phone
(770) 927-7341
Fax
(888) 700-9062
NPI assigned
Feb 1, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 187056 GA Primary

Addresses

Primary practice location

2022 Highway 92 Fairburn Rd Ste F
Douglasville, GA 30135-1062

Mailing address

618 Thornton Rd Ste 3-440
Lithia Springs, GA 30122-1518
Phone (770) 927-7341

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
I20130412000170 GA Practitioner - Nurse Practitioner 0840436010 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Piedmont Professional Services LLCGroup PAC ID 8921176231, 171 clinicians

Practice addresses (Care Compare)

1267 Hwy 54 W 2200
Fayetteville, GA 30214-2110
Phone (470) 271-3415

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
187056GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Piedmont Professional Services, LLC CurrentSince Jul 1, 2017 Accepting new patients
Piedmont Medical Care Corporation Past Accepting new patients
Piedmont Orthopedics, LLC Past Accepting new patients
Piedmont Providers LLC Past Accepting new patients

Locations

2727 Paces Ferry Rd SE
Ste 1110
Atlanta, GA 30339

1267 Highway 54 W
Ste 2200
Fayetteville, GA 30214
Phone (470) 271-3415

2779 N Cobb Pkwy NW
Kennesaw, GA 30152
Phone (678) 732-1516

695 W Crossville Rd
Roswell, GA 30075
Phone (678) 732-1531

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/327/brand/1/csg/21/fhir/r4

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.

NPI Registry JSON

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

{
    "created_epoch": "1359676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775088000000",
    "number": "1578802286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "618 THORNTON RD STE 3-440",
            "city": "LITHIA SPRINGS",
            "state": "GA",
            "postal_code": "301221518",
            "telephone_number": "770-927-7341",
            "fax_number": "888-700-9062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2022 HIGHWAY 92 FAIRBURN RD STE F",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301351062",
            "telephone_number": "770-927-7341",
            "fax_number": "888-700-9062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHARLOT",
        "first_name": "MARY",
        "middle_name": "J",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-01",
        "last_updated": "2026-04-02",
        "certification_date": "2026-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "187056",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Douglasville, GA

Sources for this page

Verify at the official NPI Registry.