Maci Merritt, FNP-C

Individual provider Active NPI Family Nurse Practitioner · Ocilla, GA

NPI 1689110496 · NPPES record last updated Jan 18, 2017

Key facts

NPI
1689110496
Entity type
Individual (NPI type 1)
Primary specialty
Family Nurse Practitioner 363LF0000X
License
RN160620 (GA)
Practice address
202 S Cherry St
Ocilla, GA 31774-1804
Phone
(229) 468-5015
NPI assigned
Jan 18, 2017
Sex
Female
Sole proprietor
No

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.

Medicare Care Compare profile

Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern Gastroenterologyand Hepatology Consultants Inc (2 clinicians)

Practice addresses (Care Compare)

300 Shirley Ave
Douglas, GA 31533-2332
Phone (912) 384-7275

Medicare participation

Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20190113000005 GA Practitioner - Nurse Practitioner 3274879291 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Gastroenterology& Hepatology Consultants Inc Current
since Oct 8, 2018
Accepting new patients

Locations

300 Shirley Ave
Douglas, GA 31533
Phone (912) 384-7275

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN160620 GA Yes

Addresses

Primary practice location

202 S Cherry St
Ocilla, GA 31774-1804

Mailing address

202 S Cherry St
Ocilla, GA 31774-1804
Phone (229) 468-5015

Other providers in Ocilla, GA

All providers in Ocilla, GA · Family Nurse Practitioner in Georgia

Sources for this page

Verify at the official NPI Registry.