Mary Jennifer Close, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

RN165558 Issued in GA

Practice address

462 Elma G Miles Pkwy Ste 102a
Hinesville, GA 31313-4000

Phone

(912) 369-9400

NPI assigned

May 31, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hospital Authority of Liberty CountyGroup PAC ID 5799772190, 15 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Liberty Regional Medical Center Hospital, Hinesville, GA, CCN 111335

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Hospital Authority of Liberty County

  dba Liberty Regional Medical Center

  • Critical Access Hospital
  • Hinesville, GA
  • NPI 1326079260
  Medicare reassignment Care Compare group NPD
• Southland Bainbridge Hospitalist Group, LLC

  • Hospitalist Physician
  • Bainbridge, GA
  • NPI 1356735336
  Medicare reassignment NPD
• Southland Optim Jenkins Emergency Medical Services, LLC

  • Emergency Medicine Physician
  • Millen, GA
  • NPI 1265826242
  Medicare reassignment NPD
• Hospital Authority of Liberty County

  dba Liberty Regional Orthopaedics

  • Orthopaedic Surgery Physician
  • Hinesville, GA
  • NPI 1023443801
  NPD
• Southland Optim Jenkins Emergency Medical Services, LLC

  dba DBA Southland Liberty Emergency Medical Services

  • Emergency Medicine Physician
  • Hinesville, GA
  • NPI 1477913580
  NPD
• Advanced Pediatric Specialists LLC

  • Pediatrics Physician
  • Savannah, GA
  • NPI 1073046397
  NPD (past)
• Wills Memorial Emergency Medical Services, LLC

  • Emergency Medicine Physician
  • Washington, GA
  • NPI 1275066326
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Hospital Authority of Liberty County

  dba Liberty Regional Medical Center

  • Critical Access Hospital
  • Hinesville, GA
  • NPI 1326079260
  Care Compare affiliation

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

{
    "created_epoch": "1212192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549497600000",
    "number": "1942468475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 S MADISON ST",
            "city": "THOMASVILLE",
            "state": "GA",
            "postal_code": "317925473",
            "telephone_number": "229-236-0831",
            "fax_number": "229-236-0871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "462 ELMA G MILES PKWY STE 102A",
            "city": "HINESVILLE",
            "state": "GA",
            "postal_code": "313134000",
            "telephone_number": "912-369-9400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLOSE",
        "first_name": "MARY",
        "middle_name": "JENNIFER",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-31",
        "last_updated": "2019-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN165558",
            "primary": true
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "GA",
            "license": "RN165558",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle Jean Clark, LPC
• Marissa Cynthia Clayton
• Mark C Clayton, D.D.S.
• Tierra Clayton
• Hannah Clements, BCBA
• Coastal Health District
• Coastal Medical Arts, LLC
• Coastal Medical Specialists
• Coastal Orthopaedics and Sports Medicine Center
• Coastal Pharmacy, Inc. (Hinesville Pharmacy)

• Nurse Practitioner in Hinesville, GA
• Providers in Hinesville, GA by specialty
• Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.