Individual provider Active NPI

Michael Scarborough, FNP-C

  • Family Nurse Practitioner
  • Decatur, GA
National Provider Identifier
1942569736
Registry record updated Sep 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F0412159 Issued in GA
Practice address
215 Church St Ste 102
Decatur, GA 30030-3330
Phone
(404) 445-0350
NPI assigned
May 14, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2020

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 F0412159 GA Primary

Addresses

Primary practice location

215 Church St Ste 102
Decatur, GA 30030-3330

Mailing address

1646 Rockcliff PL SE
Atlanta, GA 30316-4010
Phone (706) 202-6394

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
I20120927000318 GA Practitioner - Nurse Practitioner 7315196847 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Emory University School of Medicine, 2011
Medicare assignment
May accept Medicare assignment
Group practices
Positive Impact Health Centers IncGroup PAC ID 5496721987, 25 clinicians

Practice addresses (Care Compare)

523 Church St
Decatur, GA 30030-2515
Phone (404) 589-9040

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F0412159GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Grady Memorial Hospital Corporation CurrentSince Jul 9, 2012 Accepting new patients
Positive Impact Health Centers, Inc. CurrentSince Sep 7, 2021 Accepting new patients
Grady Memorial Hospital Corporation CurrentSince Jul 9, 2012 Accepting new patients
Positive Impact Health Centers Inc CurrentSince Sep 7, 2021 Accepting new patients
Qmed, LLC CurrentSince Apr 3, 2022 Accepting new patients
Grady Memorial Hospital Corporation CurrentSince Mar 24, 2024 Accepting new patients

Locations

80 Jesse Hill Jr Dr SE
Atlanta, GA 30303
Phone (404) 616-4370

80 Jesse Hill Jr Dr SE
#88
Atlanta, GA 30303
Phone (404) 616-0879

341 Ponce de Leon Ave NE
Atlanta, GA 30308
Phone (404) 616-2440

215 Church St
Ste 102
Decatur, GA 30030
Phone (404) 229-6701

523 Church St
Decatur, GA 30030
Phone (404) 589-9040

3350 Breckinridge Blvd
Ste 200
Duluth, GA 30096
Phone (770) 962-8396

3075 Breckinridge Blvd
Ste 415
Duluth, GA 30096
Phone (770) 962-8396

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/6123adb2-d0d2-485a-9dcf-5fba87efb2ef/

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1336953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600473600000",
    "number": "1942569736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1646 ROCKCLIFF PL SE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303164010",
            "telephone_number": "706-202-6394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 CHURCH ST STE 102",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300303330",
            "telephone_number": "404-445-0350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCARBOROUGH",
        "first_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-14",
        "last_updated": "2020-09-19",
        "certification_date": "2020-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "F0412159",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, GA

Sources for this page

Verify at the official NPI Registry.