Marietta Pana Olaivar-Lomboy, NP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

118138 Issued in GA

Practice address

1018 Keith Drive
Suite a
Perry, GA 31069-2948

Phone

(478) 987-7444

Fax

(478) 987-7747

NPI assigned

Aug 10, 2006

Last updated

May 11, 2015By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Emory University School of Medicine, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

South Houston Internal MedicineGroup PAC ID 1850398306, 3 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Emory Houston Hospital Warner Robins Hospital, Warner Robins, GA, CCN 110069

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: marietta.lomboy@southhoustonim.eclinicaldirectplus.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• South Houston Internal Medicine

  • Internal Medicine Physician
  • Perry, GA
  • NPI 1619089653
  Medicare reassignment Care Compare group NPD
• Cardiopulmonary Associates, P.C.

  • Cardiovascular Disease Physician
  • Macon, GA
  • NPI 1023183399
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Houston Hospitals Inc

  dba Emory Hospital Perry

  • General Acute Care Hospital
  • Perry, GA
  • NPI 1891808499
  Care Compare affiliation
• Houston Hospitals Inc

  dba Emory Hospital Warner Robins

  • General Acute Care Hospital
  • Warner Robins, GA
  • NPI 1962435792
  Care Compare affiliation

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

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431302400000",
    "number": "1699786327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1018 KEITH DR",
            "address_2": "SUITE A",
            "city": "PERRY",
            "state": "GA",
            "postal_code": "310692947",
            "telephone_number": "478-987-7444",
            "fax_number": "478-987-7747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1018 KEITH DRIVE",
            "address_2": "SUITE A",
            "city": "PERRY",
            "state": "GA",
            "postal_code": "310692948",
            "telephone_number": "478-987-7444",
            "fax_number": "478-987-7747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLAIVAR-LOMBOY",
        "first_name": "MARIETTA",
        "middle_name": "PANA",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-10",
        "last_updated": "2015-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "GA",
            "license": "118138",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• New Pointe Treatment Center
• Jessica Niederkorn, M.A., CCC-SLP
• Jepthe Nkwanmen, RN
• Obstetrics of Perry, PC
• Melissa Terry Olah, PA-C
• Mary Ann Orr, M.ED. CCC-SLP
• Kimberly Clarisse Parker, OTL
• Hiren B. Patel, O.D.
• Patterson Chiropractic Clinic
• Eugenia Patterson, RN

• Adult Health Nurse Practitioner in Perry, GA
• Providers in Perry, GA by specialty
• Adult Health Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.