Individual provider Active NPI

Mary Elizabeth Buck, CNP

  • Nurse Practitioner
  • Savannah, GA
National Provider Identifier
1871665208
Registry record updated Oct 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN-NP072464 Issued in GA
Practice address
1139 Lexington Ave
Ste a
Savannah, GA 31404-5502
Phone
(912) 303-4200
Fax
(912) 790-2701
NPI assigned
Nov 14, 2006
Last updated
Oct 9, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2025

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 APRN-NP072464 GA Primary

Addresses

Primary practice location

1139 Lexington Ave
Ste a
Savannah, GA 31404-5502

Mailing address

1139 Lexington Ave Ste a
Savannah, GA 31404-5502
Phone (912) 303-4200

Other identifiers 2

IdentifierTypeStateIssuer
000818133BMedicaidGA
50BBHNCOtherGAMEDICARE PTAN

Other names 1

  • Mary Elizabeth Yates Former name

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
I20040716000086 GA Practitioner - Nurse Practitioner 0143209833 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aga, LLCGroup PAC ID 2365431350, 138 clinicians
Aga Professional Services LLCGroup PAC ID 3870768997, 175 clinicians

Practice addresses (Care Compare)

1139 Lexington Ave
Suite a
Savannah, GA 31404-5502
Phone (913) 203-4200

2520 Windy Hill Rd SE
Suite 102
Marietta, GA 30067-8633
Phone (770) 612-8165

488 Kennesaw Ave NW
Suite 200
Marietta, GA 30060-9409
Phone (770) 427-3075

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
74.39 of 100Reported as group
Quality
44.91
Promoting interoperability
98
Improvement activities
40
Cost
71.38

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN-NP072464GAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Aga Professional Services, LLC CurrentSince Oct 10, 2019 Accepting new patients
Aga, LLC CurrentSince Oct 10, 2019 Accepting new patients
Endoscopy Center LLC Past Accepting new patients

Locations

2520 Windy Hill Rd SE
Ste 102
Marietta, GA 30067
Phone (770) 612-8165

488 Kennesaw Ave NW
Ste 200
Marietta, GA 30060
Phone (770) 427-3075

1139 Lexington Ave
Savannah, GA 31404
Phone (912) 303-4200

1139 Lexington Ave
Ste A
Savannah, GA 31404
Phone (912) 303-4200

Interoperability endpoints

  • Direct secure messaging: elizabeth.buck@ud.eclinicaldirectplus.com
  • FHIR API: https://fhir-myrecord.cerner.com/r4/d88010de-d791-42d4-b72d-513f9afc5ed1/

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759968000000",
    "number": "1871665208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1139 LEXINGTON AVE STE A",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314045502",
            "telephone_number": "912-303-4200",
            "fax_number": "912-790-2701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1139 LEXINGTON AVE",
            "address_2": "STE A",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314045502",
            "telephone_number": "912-303-4200",
            "fax_number": "912-790-2701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCK",
        "first_name": "MARY",
        "middle_name": "ELIZABETH",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-14",
        "last_updated": "2025-10-09",
        "certification_date": "2025-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "APRN-NP072464",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000818133B",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "50BBHNC",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "YATES",
            "middle_name": "ELIZABETH",
            "credential": "CNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Savannah, GA

Sources for this page

Verify at the official NPI Registry.