Individual provider Active NPI

Michael Cuellar, FNP-C

  • Family Nurse Practitioner
  • Warner Robins, GA
National Provider Identifier
1992542286
Registry record updated Jul 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN204647 Issued in GA
Practice address
301 Margie Dr
Warner Robins, GA 31088-7818
Phone
(478) 971-1153
NPI assigned
Jul 12, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2024

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 RN204647 GA Primary

Addresses

Primary practice location

301 Margie Dr
Warner Robins, GA 31088-7818

Mailing address

3708 Northside Dr
Macon, GA 31210-2404
Phone (478) 745-4206

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
I20240808004128 GA Practitioner - Nurse Practitioner 3577000421 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

301 Margie Dr
Warner Robins, GA 31088-7818
Phone (478) 971-1153

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN204647GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Macon Orthopaedic & Hand Center, PA CurrentSince Jul 25, 2024 Accepting new patients
Macon Orthopaedic & Hand Center, PA CurrentSince Jul 25, 2024 Accepting new patients

Locations

3708 Northside Dr
Bldg A
Macon, GA 31210

3708 Northside Dr
Macon, GA 31210
Phone (478) 254-5303

301 Margie Dr
Warner Robins, GA 31088
Phone (478) 953-5800

Interoperability endpoints

  • Direct secure messaging: mike.cuellar.1@4291.direct.athenahealth.com

Organizations & group practices 2

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": "1720742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720742400000",
    "number": "1992542286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3708 NORTHSIDE DR",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312102404",
            "telephone_number": "478-745-4206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 MARGIE DR",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "310887818",
            "telephone_number": "478-971-1153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUELLAR",
        "first_name": "MICHAEL",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-07-12",
        "last_updated": "2024-07-12",
        "certification_date": "2024-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN204647",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warner Robins, GA

Sources for this page

Verify at the official NPI Registry.