Individual provider Active NPI

Mary McLain

  • Nurse Practitioner
  • Atlanta, GA
National Provider Identifier
1639804594
Registry record updated Aug 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
LPN035931 Issued in GA
Practice address
550 Peachtree St NE
Atlanta, GA 30308-2212
Phone
(470) 992-3658
Fax
(470) 264-7038
NPI assigned
Jul 23, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 035931 GA
Nurse Practitioner 363L00000X RN035931 GA
Nurse Practitioner 363L00000X LPN035931 GA Primary

Addresses

Primary practice location

550 Peachtree St NE
Atlanta, GA 30308-2212

Mailing address

PO Box 371795
Decatur, GA 30037-1795
Phone (470) 992-3658

Other practice location 1

2700 Hospital Dr
Northport, AL 35476-3360
Phone (470) 992-3658

Other practice location 2

1968 Peachtree Rd NW
Atlanta, GA 30309-1281
Phone (470) 992-3658

Other practice location 3

1000 Johnson Fy Rd NE
Atlanta, GA 30342-1611
Phone (470) 992-3658

Other identifiers 1

IdentifierTypeStateIssuer
1609536549OtherNPPES

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

LicenseStateTypeSpecialty
035931GAMDFamily Medicine Physician
LPN035931GAMDNurse Practitioner
RN035931GAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Emory University Hospital Midtown Family Medicine CurrentSince Aug 7, 2022 Accepting new patients

Locations

1968 Ptree Rd NW
Atlanta, GA 30309
Phone (404) 605-2222

1000 Johnson Fy Rd NE
Sandy Springs, GA 30342
Phone (404) 851-1000

Organizations & group practices 1

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": "1658534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693267200000",
    "number": "1639804594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 371795",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300371795",
            "telephone_number": "470-992-3658",
            "fax_number": "470-264-7038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 PEACHTREE ST NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303082212",
            "telephone_number": "470-992-3658",
            "fax_number": "470-264-7038"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2700 Hospital Dr",
            "address_purpose": "LOCATION",
            "city": "Northport",
            "state": "AL",
            "postal_code": "354763360",
            "country_code": "US",
            "telephone_number": "470-992-3658",
            "fax_number": "470-264-7038",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1968 Peachtree Rd NW",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303091281",
            "country_code": "US",
            "telephone_number": "470-992-3658",
            "fax_number": "470-264-7038",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1000 Johnson Fy Rd NE",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303421611",
            "country_code": "US",
            "telephone_number": "470-992-3658",
            "fax_number": "470-264-7038",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCLAIN",
        "first_name": "MARY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-23",
        "last_updated": "2023-08-29",
        "certification_date": "2023-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "035931",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN035931",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "LPN035931",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPPES",
            "identifier": "1609536549",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2023; 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.