Individual provider Active NPI

Mary Ann Camp, FNP-C

  • Nurse Practitioner
  • Douglas, GA
National Provider Identifier
1912601832
Registry record updated Mar 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN286616 Issued in GA
Practice address
1101 Ocilla Rd
Douglas, GA 31533-2207
Phone
(912) 384-1900
NPI assigned
Mar 27, 2023
Last updated
Mar 27, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2023

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 RN286616 GA Primary

Addresses

Primary practice location

1101 Ocilla Rd
Douglas, GA 31533-2207

Mailing address

350 Deer Run Rd
Nicholls, GA 31554-6183
Phone (229) 425-2964

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
I20251017003034 GA Practitioner - Nurse Practitioner 6204323678 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
CRH Physician Practices, LLCGroup PAC ID 5193727964, 38 clinicians

Practice addresses (Care Compare)

1305 Ocilla Rd
Douglas, GA 31533-2209
Phone (912) 384-0600

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN286616GAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
CRH Physician Practices, LLC CurrentSince Jul 18, 2025 Accepting new patients

Locations

1305 Ocilla Rd
Douglas, GA 31533
Phone (912) 384-0600

182 Perry House Rd
Ste F
Fitzgerald, GA 31750
Phone (478) 257-5533

1508 Tebeau St
Waycross, GA 31501
Phone (912) 383-6575

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

NPI Registry JSON

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

{
    "created_epoch": "1679875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679875200000",
    "number": "1912601832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 DEER RUN RD",
            "city": "NICHOLLS",
            "state": "GA",
            "postal_code": "315546183",
            "telephone_number": "229-425-2964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 OCILLA RD",
            "city": "DOUGLAS",
            "state": "GA",
            "postal_code": "315332207",
            "telephone_number": "912-384-1900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMP",
        "first_name": "MARY",
        "middle_name": "ANN",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-27",
        "last_updated": "2023-03-27",
        "certification_date": "2023-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN286616",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Douglas, GA

Sources for this page

Verify at the official NPI Registry.