NPIMap

Organization Active NPI

Mercy Medical Clinic

  • Community Health Clinic/Center
  • Vidalia, GA
National Provider Identifier
1609138692
Registry record updated Jun 14, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Clinic/CenterTaxonomy code 261QC1500X
License
RN060662 Issued in GA
Legal business name
MERCY MEDICAL CLINIC
Practice address
300 Arlington Dr
Vidalia, GA 30474-8935
Phone
(912) 538-0523
Fax
(912) 538-8945
NPI assigned
Jun 14, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2012

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

Authorized official

Name
Dr. Nancy Stanley, DPT
Title
Community Wellness Department Direc
Phone
(912) 538-0523

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Clinic/Center 261QC1500X RN060662 GA Primary

Addresses

Primary practice location

300 Arlington Dr
Vidalia, GA 30474-8935

Mailing address

300 Arlington Dr
Vidalia, GA 30474-8935
Phone (912) 538-0523

National Provider Directory

National Provider Directory

Locations

300 Arlington Dr
Vidalia, GA 30474
Phone (800) 599-0067

NPI Registry JSON

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

{
    "created_epoch": "1339632000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1339632000000",
    "number": "1609138692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 ARLINGTON DR",
            "city": "VIDALIA",
            "state": "GA",
            "postal_code": "304748935",
            "telephone_number": "912-538-0523",
            "fax_number": "912-538-8945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 ARLINGTON DR",
            "city": "VIDALIA",
            "state": "GA",
            "postal_code": "304748935",
            "telephone_number": "912-538-0523",
            "fax_number": "912-538-8945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCY MEDICAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-14",
        "last_updated": "2012-06-14",
        "status": "A",
        "authorized_official_last_name": "STANLEY",
        "authorized_official_first_name": "NANCY",
        "authorized_official_title_or_position": "COMMUNITY WELLNESS DEPARTMENT DIREC",
        "authorized_official_telephone_number": "912-538-0523",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": "GA",
            "license": "RN060662",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vidalia, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.