Individual provider Active NPI

Marion Craig Horton, M.D.

  • Pediatrics Physician
  • Vidalia, GA
National Provider Identifier
1861402885
Registry record updated Sep 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
28788 Issued in GA
Practice address
125 Church St
Vidalia, GA 30474-4770
Phone
(912) 538-8484
NPI assigned
Aug 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 28788 GA Primary

Addresses

Primary practice location

125 Church St
Vidalia, GA 30474-4770

Mailing address

PO Box 407
Vidalia, GA 30475-0407
Phone (912) 537-4986

Other identifiers 1

IdentifierTypeStateIssuer
000345584EMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
28788GAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vidalia Children'S Center LLC Pediatrics Current Accepting new patients

Locations

125 Church St
Vidalia, GA 30474
Phone (912) 538-8484

Interoperability endpoints

  • Direct secure messaging: craig.horton@vcc.gadirect.net
  • Direct secure messaging: craig.horton@mrmc.gadirect.net

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.

NPI Registry JSON

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

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409616000000",
    "number": "1861402885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 407",
            "city": "VIDALIA",
            "state": "GA",
            "postal_code": "304750407",
            "telephone_number": "912-537-4986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 CHURCH ST",
            "city": "VIDALIA",
            "state": "GA",
            "postal_code": "304744770",
            "telephone_number": "912-538-8484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HORTON",
        "first_name": "MARION",
        "middle_name": "CRAIG",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-09",
        "last_updated": "2014-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "28788",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000345584E",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vidalia, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.