Individual provider Active NPI

Mark G Hebert, NP-C

  • Nurse Practitioner
  • Atlanta, GA
National Provider Identifier
1831268630
Registry record updated Jun 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN116170 Issued in GA
Practice address
2140 Peachtree Rd NW
Suite 232
Atlanta, GA 30309-1314
Phone
(404) 231-4431
Fax
(404) 231-5677
NPI assigned
Nov 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN116170 GA Primary
Nurse Practitioner 363L00000X RN116170 NP GA

Addresses

Primary practice location

2140 Peachtree Rd NW
Suite 232
Atlanta, GA 30309-1314

Mailing address

2140 Peachtree Rd NW Ste 232
Atlanta, GA 30309-1316
Phone (404) 231-4431

Other identifiers 2

IdentifierTypeStateIssuer
702601976AMedicaidGA
208628511AMedicaidGA

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
I20080204000091 GA Practitioner - Nurse Practitioner 3173605839 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medcura Health, Inc 15 clinicians
Long'S Drugs of Sandersville Georgia Inc 13 clinicians

Practice addresses (Care Compare)

2140 Peachtree Rd NW
Suite 232
Atlanta, GA 30309-1316
Phone (404) 231-4431

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN116170GAMDNurse Practitioner
RN116170 NPGAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Long'S Drugs of Sandersville, Georgia, Inc. CurrentSince Oct 3, 2022 Accepting new patients
Medcura Health, Inc. Current Accepting new patients
Medcura Health, Inc. CurrentSince Jun 1, 2018 Accepting new patients
Medcura Health, Inc. CurrentSince Jun 1, 2018 Accepting new patients
Longs Drugs of Sandersville Georgia Inc CurrentSince Oct 3, 2022 Accepting new patients
Medcura Health, Inc. Past Accepting new patients

Locations

2140 Peachtree Rd NW
Atlanta, GA 30309
Phone (404) 351-4114

2140 Peachtree Rd NW
Ste 232
Atlanta, GA 30309
Phone (888) 708-0561

5582 Memorial Dr
Stone Mountain, GA 30083
Phone (404) 513-9965

770 Village Square Dr
Stone Mtn, GA 30083
Phone (404) 298-7658

10604 Coursey Blvd
Baton Rouge, LA 70816
Phone (225) 236-1543

Interoperability endpoints

  • Direct secure messaging: mark.hebert@avc.eclinicaldirectplus.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/FHEECD
  • Direct secure messaging: mark.herbert@abcare.gadirect.net

Organizations & group practices 18

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.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529107200000",
    "number": "1831268630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2140 PEACHTREE RD NW STE 232",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303091316",
            "telephone_number": "404-231-4431",
            "fax_number": "404-231-5677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2140 PEACHTREE RD NW",
            "address_2": "SUITE 232",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303091314",
            "telephone_number": "404-231-4431",
            "fax_number": "404-231-5677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEBERT",
        "first_name": "MARK",
        "middle_name": "G",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-07",
        "last_updated": "2018-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN116170",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN116170 NP",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "702601976A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "208628511A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.