Mariel Danita Hepburn

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

074668 Issued in GA

Practice address

611 E Washington Ave
Ashburn, GA 31714-5315

Phone

(229) 567-3407

Fax

(229) 567-4467

NPI assigned

Apr 30, 2012

Last updated

Mar 8, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mariel.hepburn@trhs.cernerdirect.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.

• Tift Regional Health System Inc

  dba Allure Plastic & Reconstructive Surgery

  • Plastic Surgery Physician
  • Tifton, GA
  • NPI 1316268196
  NPD
• Tift Regional Health System Inc

  dba Tift Regional Ophthalmology

  • Ophthalmology Physician
  • Tifton, GA
  • NPI 1790280857
  NPD

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

{
    "created_epoch": "1335744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615161600000",
    "number": "1851659650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "907 18TH ST E STE 400",
            "city": "TIFTON",
            "state": "GA",
            "postal_code": "317943684",
            "telephone_number": "229-353-3422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 E WASHINGTON AVE",
            "city": "ASHBURN",
            "state": "GA",
            "postal_code": "317145315",
            "telephone_number": "229-567-3407",
            "fax_number": "229-567-4467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEPBURN",
        "first_name": "MARIEL",
        "middle_name": "DANITA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-30",
        "last_updated": "2021-03-08",
        "certification_date": "2021-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "074668",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mariel.hepburn@trhs.cernerdirect.com",
            "affiliation": "N",
            "address_1": "611 E Washington Ave",
            "city": "Ashburn",
            "state": "GA",
            "country_code": "US",
            "postal_code": "317145315",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Megan Logue Gibbs, FNP-BC
• Gracefield Personal Care LLC
• Cherysh L Green-Caldwell, LMSW
• Daryl Hall
• Wendy M Hancock, RDH
• Montakesha Range Hillmon
• Mary Grace Hobby I, CCC-SLP
• Wallis Hobby, D.M.D.
• Kathy McLeod (R & M Cash Drugs)
• Patrina Lockette, M.D.

• Family Medicine Physician in Ashburn, GA
• Providers in Ashburn, GA by specialty
• Family Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.