NPIMap

Individual provider Active NPI

Cidney Peel Merritt, CRNP

  • Family Nurse Practitioner
  • Dothan, AL
National Provider Identifier
1891281911
Registry record updated Jul 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1-149410 Issued in AL
Practice address
1500 Ross Clark Cir
Dothan, AL 36301-4754
Phone
(334) 793-2663
Fax
(334) 836-2248
NPI assigned
Jul 2, 2018
Last updated
Jul 2, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1-149410 AL Primary

Addresses

Primary practice location

1500 Ross Clark Cir
Dothan, AL 36301-4754

Mailing address

1500 Ross Clark Cir
Dothan, AL 36301-4754
Phone (334) 793-2663

Other practice location 1

345 Healthwest Dr
Dothan, AL 36303-2053
Phone (334) 793-2663

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180828004152 AL Practitioner - Nurse Practitioner 4284984097 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
S.B.J.S. PCGroup PAC ID 8527043421, 39 clinicians

Practice addresses (Care Compare)

1500 Ross Clark Cir
Dothan, AL 36301-4754
Phone (334) 793-2663

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1-149410ALMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
SBJS PC CurrentSince Sep 3, 2018 Accepting new patients
S.B.J.S. PC CurrentSince Sep 3, 2018 Accepting new patients
Hospital Authority of the City of Bainbridge and Decatur County Past Accepting new patients
S.B.J.S. PC Past Accepting new patients

Locations

1500 Ross Clark Cir
Dothan, AL 36301
Phone (334) 793-2663

345 Healthwest Dr
Dothan, AL 36303
Phone (334) 793-2663

2126 W Roy Parker Rd
Ste 201
Ozark, AL 36360
Phone (334) 445-2663

Interoperability endpoints

  • Direct secure messaging: cidney.merritt.1@15455.direct.athenahealth.com

Organizations & group practices 4

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 4

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": "1530489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530489600000",
    "number": "1891281911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 ROSS CLARK CIR",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363014754",
            "telephone_number": "334-793-2663",
            "fax_number": "334-836-2248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 ROSS CLARK CIR",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363014754",
            "telephone_number": "334-793-2663",
            "fax_number": "334-836-2248"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "345 Healthwest Dr",
            "address_purpose": "LOCATION",
            "city": "Dothan",
            "state": "AL",
            "postal_code": "363032053",
            "country_code": "US",
            "telephone_number": "334-793-2663",
            "fax_number": "334-836-2248",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MERRITT",
        "first_name": "CIDNEY",
        "middle_name": "PEEL",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-02",
        "last_updated": "2018-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-149410",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dothan, AL

Sources for this page

Verify at the official NPI Registry.