Mary Beth Bruner Tharp, CPNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

RN104841 Issued in GA

Practice address

85 John Maddox Drive Connector NW
Rome, GA 30165-1233

Phone

(762) 235-2990

Fax

(706) 238-8031

NPI assigned

Jan 12, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Mary Beth Bruner Other name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Pediatric Nurse Practitioner, Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Harbin Clinic, LLC

  dba Harbin GI

  • Ambulatory Surgical Clinic/Center
  • Rome, GA
  • NPI 1447385158
  NPD

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

{
    "created_epoch": "1168560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595289600000",
    "number": "1689724411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 TECHNOLOGY PKWY NW",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301651369",
            "telephone_number": "762-235-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 JOHN MADDOX DRIVE CONNECTOR NW",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301651233",
            "telephone_number": "762-235-2990",
            "fax_number": "706-238-8031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THARP",
        "first_name": "MARY BETH",
        "middle_name": "BRUNER",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-12",
        "last_updated": "2020-07-21",
        "certification_date": "2020-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN104841",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000706373E",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mary.beth.tharp.1@1498.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "85 John Maddox Drive Connector NW",
            "city": "Rome",
            "state": "GA",
            "country_code": "US",
            "postal_code": "301651233",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MARY BETH",
            "last_name": "BRUNER",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Jason Daniel Terry, COTA
• James M Terzian, M.D.
• Chante Simone Testamark-Hill
• Harivansh Thakar
• Jacques C Tham, MD
• THC Inc
• The Bridge Private Homecare Services
• The Calm Center Inc.
• The Delaino Clinic of Chiropractic
• The Family Health Centers of Georgia, Inc

• Nurse Practitioner in Rome, GA
• Providers in Rome, GA by specialty
• Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2020; 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.