NPIMap

Individual provider Active NPI

Marian Symmes Johnson

  • Gynecologic Oncology Physician
  • Macon, GA
National Provider Identifier
1740579390
Registry record updated Aug 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecologic Oncology PhysicianTaxonomy code 207VX0201X
License
80122 Issued in GA
Practice address
682 Hemlock St Ste 210
Macon, GA 31201
Phone
(478) 633-6090
NPI assigned
Apr 5, 2011
Last updated
Aug 4, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecologic Oncology Physician 207VX0201X 80122 GA Primary

Addresses

Primary practice location

682 Hemlock St Ste 210
Macon, GA 31201

Mailing address

3696 Wheeler Rd
Augusta, GA 30909-6520
Phone (706) 736-1830

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180917001722 GA Practitioner - Gynecological Oncology 3173874039 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Gynecological Oncology
Education
Medical University of South Carolina College of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Wellstar Medical Group LLCGroup PAC ID 6709065402, 3,059 clinicians
Augusta Oncology Associates PCGroup PAC ID 8921089756, 36 clinicians

Practice addresses (Care Compare)

1120 15TH St
Augusta, GA 30912-0004
Phone (706) 721-8623

1303 Dantignac St
Suite 1000
Augusta, GA 30901-2776
Phone (706) 821-2944

5150 Stilesboro N W Rd
Suite 220
Kennesaw, GA 30152-7742
Phone (770) 424-8222

989 Saint Sebastian Way
Augusta, GA 30912-0004
Phone (706) 721-2171

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.93 of 100Reported as apm
Quality
82.14
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
82.47 of 100Reported as group
Quality
41.03
Promoting interoperability
97
Improvement activities
40
Cost
98.45

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus18

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
80122GAMDGynecologic Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Au Medical Associates Inc CurrentSince Aug 1, 2021 Accepting new patients
Augusta Oncology Associates PC CurrentSince Sep 1, 2021 Accepting new patients
Wellstar Medical Group, LLC CurrentSince Sep 1, 2023 Accepting new patients
Wellstar Medical Group, LLC Current Accepting new patients
Au Medical Associates Inc CurrentSince Aug 1, 2021 Accepting new patients
Augusta Oncology Associates PC Gynecologic Oncology CurrentSince Sep 1, 2021 Accepting new patients
Au Medical Center, Inc Past Accepting new patients

Locations

1120 15th St
Augusta, GA 30912
Phone (706) 721-3873

1303 Dantignac St
Ste 1000
Augusta, GA 30901
Phone (706) 736-1830

3696 Wheeler Rd
Augusta, GA 30909
Phone (706) 736-1830

5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222

Organizations & group practices 7

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.

Hospital & facility affiliations 6

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": "1301961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628035200000",
    "number": "1740579390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3696 WHEELER RD",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309096520",
            "telephone_number": "706-736-1830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "682 HEMLOCK ST STE 210",
            "city": "MACON",
            "state": "GA",
            "postal_code": "31201",
            "telephone_number": "478-633-6090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MARIAN",
        "middle_name": "SYMMES",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-05",
        "last_updated": "2021-08-04",
        "certification_date": "2021-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VX0201X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecologic Oncology",
            "state": "GA",
            "license": "80122",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Macon, GA

Sources for this page

Verify at the official NPI Registry.