Individual provider Active NPI

Amy Carmichael Maresca, NP

  • Family Nurse Practitioner
  • Decatur, GA
National Provider Identifier
1740612985
Registry record updated Apr 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN195223 Issued in GA
Practice address
315 W Ponce de Leon Ave Ste 110
Decatur, GA 30030-2441
Phone
(770) 312-3562
NPI assigned
Jul 30, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 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 RN195223 GA Primary

Addresses

Primary practice location

315 W Ponce de Leon Ave Ste 110
Decatur, GA 30030-2441

Mailing address

2792 Smithsonia Way
Tucker, GA 30084-2617
Phone (770) 312-3562

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
I20130913000139 GA Practitioner - Nurse Practitioner 5890939821 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ponce Preventive Care LLCGroup PAC ID 6406987544, 10 clinicians

Practice addresses (Care Compare)

315 W Ponce de Leon Ave
Suite 110
Decatur, GA 30030-2441
Phone (404) 537-2521

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ponce Preventive Care LLC CurrentSince Oct 17, 2022 Accepting new patients

Locations

315 W Ponce de Leon Ave
Ste 110
Decatur, GA 30030
Phone (404) 371-9673

Interoperability endpoints

  • Direct secure messaging: amy.maresca.1@9773.direct.athenahealth.com

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 3

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": "1375142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745280000000",
    "number": "1740612985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2792 SMITHSONIA WAY",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300842617",
            "telephone_number": "770-312-3562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 W PONCE DE LEON AVE STE 110",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300302441",
            "telephone_number": "770-312-3562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARESCA",
        "first_name": "AMY",
        "middle_name": "CARMICHAEL",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-30",
        "last_updated": "2025-04-22",
        "certification_date": "2025-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN195223",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, GA

Sources for this page

Verify at the official NPI Registry.