Individual provider Active NPI

Mark A Plunkett, M.D. OB/GYN

  • Obstetrics & Gynecology Physician
  • Fort Benning, GA
National Provider Identifier
1659323301
Registry record updated Jun 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
70932 Issued in GA
Practice address
6600 Van Aalst Blvd
Fort Benning, GA 31905-2102
Phone
(762) 408-2605
NPI assigned
May 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 70932 GA Primary

Addresses

Primary practice location

6600 Van Aalst Blvd
Fort Benning, GA 31905-2102

Mailing address

PO Box 9186
Wvu Dept of Obstetrics and Gynecology
Morgantown, WV 26506-9186
Phone (304) 293-5631

Other identifiers 1

IdentifierTypeStateIssuer
200377920MedicaidIN

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221118002222 GA Practitioner - Obstetrics/Gynecology 1658356506 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Alabama School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
DHP of Piedmont PCGroup PAC ID 9133378763, 18 clinicians

Practice addresses (Care Compare)

1255 Hwy 54 W
Fayetteville, GA 30214-4526
Phone (770) 719-7339

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
70932GAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
DHP of Piedmont PC Obstetrics & Gynecology CurrentSince Dec 1, 2022 Accepting new patients
The Medical Center Inc Past Accepting new patients

Locations

710 Center St
Columbus, GA 31901
Phone (706) 571-1000

1255 Highway 54 W
Fayetteville, GA 30214
Phone (770) 719-6911

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": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622592000000",
    "number": "1659323301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9186",
            "address_2": "WVU DEPT OF OBSTETRICS AND GYNECOLOGY",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265069186",
            "telephone_number": "304-293-5631",
            "fax_number": "304-293-2131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6600 VAN AALST BLVD",
            "city": "FORT BENNING",
            "state": "GA",
            "postal_code": "319052102",
            "telephone_number": "762-408-2605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PLUNKETT",
        "first_name": "MARK",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D. OB/GYN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-17",
        "last_updated": "2021-06-02",
        "certification_date": "2021-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "GA",
            "license": "70932",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200377920",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Benning, GA

Sources for this page

Verify at the official NPI Registry.