Memori McCarley Waters, CPNP-PC

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

RN202155 Issued in GA

Practice address

1112 W 12TH St
Alma, GA 31510-1814

Phone

(912) 632-8244

Fax

(912) 632-7041

NPI assigned

Dec 7, 2015

Last updated

Mar 29, 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 1

Addresses

Other names 1

• Memori Kay McCarley Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: memori.mccarley@vcc.gadirect.net

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.

• Vidalia Children's Center LLC

  • Pediatrics Physician
  • Vidalia, GA
  • NPI 1679705115
  NPD
• South Georgia Primary Care, Inc.

  dba South Georgia Pediatric Care

  • Pediatrics Physician
  • Alma, GA
  • NPI 1689935306
  NPD (past)

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

{
    "created_epoch": "1449446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616976000000",
    "number": "1902271604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1112 W 12TH ST",
            "city": "ALMA",
            "state": "GA",
            "postal_code": "315101814",
            "telephone_number": "912-632-8244",
            "fax_number": "912-632-7041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1112 W 12TH ST",
            "city": "ALMA",
            "state": "GA",
            "postal_code": "315101814",
            "telephone_number": "912-632-8244",
            "fax_number": "912-632-7041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATERS",
        "first_name": "MEMORI",
        "middle_name": "MCCARLEY",
        "name_prefix": "Mrs.",
        "credential": "CPNP-PC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-07",
        "last_updated": "2021-03-29",
        "certification_date": "2021-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "GA",
            "license": "RN202155",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MEMORI",
            "last_name": "MCCARLEY",
            "middle_name": "KAY",
            "credential": "CPNP-PC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Unison Behavioral Health
• Unison Behavioral Health
• Allen Michael Vergen, DMD
• Walgreen Co (Walgreens #18095)
• Trent Ware, PT, DPT
• We Care Family Practice, Inc.
• Savannah Paige Welch, OT
• Amy Williams, PHARMD
• Sharonda Latrell Williams, LPN

• Pediatric Nurse Practitioner in Alma, GA
• Providers in Alma, GA by specialty
• Pediatric Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2021; 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.