Individual provider Active NPI

Marianne A Mainer, NP

  • Nurse Practitioner
  • Savannah, GA
National Provider Identifier
1861868481
Registry record updated Jun 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN209207 Issued in GA
Practice address
5 Executive Cir
Savannah, GA 31406-3345
Phone
(912) 691-1533
Fax
(912) 691-1953
NPI assigned
Aug 18, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN209207 GA Primary

Addresses

Primary practice location

5 Executive Cir
Savannah, GA 31406-3345

Mailing address

5 Executive Cir
Savannah, GA 31406-3345
Phone (912) 691-1533

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
I20151021001052 GA Practitioner - Nurse Practitioner 8426367061 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wound Care Clinic - Esu, Inc.Group PAC ID 9436178910, 4 clinicians

Practice addresses (Care Compare)

1215 US Hwy 80 E
Suite 700
Pooler, GA 31322-9566
Phone (912) 998-0040

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Wound Care Clinic - Esu, Inc. CurrentSince Apr 1, 2025 Accepting new patients
Pineland Area Community Services Board CurrentSince Jun 1, 2020 Accepting new patients
Advanced Pediatric Specialists LLC Past Accepting new patients

Locations

1215 US Highway 80 E
Ste 700
Pooler, GA 31322
Phone (912) 998-0040

4 W Altman St
Statesboro, GA 30458
Phone (912) 764-6129

Organizations & group practices 3

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": "1439856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466467200000",
    "number": "1861868481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 EXECUTIVE CIR",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314063345",
            "telephone_number": "912-691-1533",
            "fax_number": "912-691-1953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 EXECUTIVE CIR",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314063345",
            "telephone_number": "912-691-1533",
            "fax_number": "912-691-1953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAINER",
        "first_name": "MARIANNE",
        "middle_name": "A",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-18",
        "last_updated": "2016-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN209207",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Savannah, GA

Sources for this page

Verify at the official NPI Registry.