Individual provider Active NPI

Mary Rose Evans, FNP-C

  • Family Nurse Practitioner
  • Macon, GA
National Provider Identifier
1740073162
Registry record updated May 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN248141 Issued in GA
Practice address
3951 Ridge Ave Ste B
Macon, GA 31210-5063
Phone
(478) 757-1934
Fax
(478) 757-1596
NPI assigned
May 28, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2025

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 RN248141 GA Primary

Addresses

Primary practice location

3951 Ridge Ave Ste B
Macon, GA 31210-5063

Mailing address

1831 Reedy Creek Rd
Forsyth, GA 31029-7733
Phone (478) 951-8576

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
I20251112000590 GA Practitioner - Nurse Practitioner 7214428846 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3951 Ridge Ave
Suite B
Macon, GA 31210-5048

3951 Ridge Ave
Suite B
Macon, GA 31210-5063

Hospital & facility affiliations

  • Atrium Health Navicent the Medical Center Hospital, Macon, GA, CCN 110107

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN248141GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Nicholas a Pietrzak, MD, LLC CurrentSince Oct 1, 2025 Accepting new patients

Locations

3951 Ridge Ave
Ste B
Macon, GA 31210
Phone (478) 757-1934

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JAICAA

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1748390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748390400000",
    "number": "1740073162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1831 REEDY CREEK RD",
            "city": "FORSYTH",
            "state": "GA",
            "postal_code": "310297733",
            "telephone_number": "478-951-8576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3951 RIDGE AVE STE B",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312105063",
            "telephone_number": "478-757-1934",
            "fax_number": "478-757-1596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "MARY",
        "middle_name": "ROSE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-05-28",
        "last_updated": "2025-05-28",
        "certification_date": "2025-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN248141",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Macon, GA

Sources for this page

Verify at the official NPI Registry.