Individual provider Active NPI

Merrilea W Reeves, NP

  • Family Nurse Practitioner
  • McDonough, GA
National Provider Identifier
1649439530
Registry record updated Jun 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN045410 Issued in GA
Practice address
80 Vinings Dr
McDonough, GA 30253-5994
Phone
(770) 302-6780
Fax
(678) 782-3776
NPI assigned
Jun 5, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2016

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 RN045410 GA Primary

Addresses

Primary practice location

80 Vinings Dr
McDonough, GA 30253-5994

Mailing address

290 Country Club Dr
Suite 220
Stockbridge, GA 30281-9069
Phone (770) 302-6780

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
I20241127001180 GA Order and Referring Only - Nurse Practitioner 4385717081

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN045410GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Correctmed Locust Grove, LLC CurrentSince Feb 25, 2013 Accepting new patients
Tri County Medical Associates PC Past Accepting new patients

Locations

4861 Bill Gardner Pkwy
Ste 100
Locust Grove, GA 30248
Phone (770) 626-5580

4861 Bill Gardner Pkwy
#100
Locust Grove, GA 30248
Phone (770) 626-5740

9020 Peridot Pkwy
Stockbridge, GA 30281
Phone (770) 626-5580

Organizations & group practices 2

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": "1212624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466640000000",
    "number": "1649439530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "290 COUNTRY CLUB DR",
            "address_2": "SUITE 220",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302819069",
            "telephone_number": "770-302-6780",
            "fax_number": "678-782-3776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 VININGS DR",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302535994",
            "telephone_number": "770-302-6780",
            "fax_number": "678-782-3776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REEVES",
        "first_name": "MERRILEA",
        "middle_name": "W",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-05",
        "last_updated": "2016-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN045410",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McDonough, GA

Sources for this page

Verify at the official NPI Registry.