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MARY CRUMBLISS MSN, CPNP-PC
NPI 1144825415
Nurse Practitioner in Johns Creek, GA

Active since December 03, 2020PECOS Enrolled
10710 MEDLOCK BRIDGE RD STE 250, JOHNS CREEK, GA 30097(770) 870-1085(770) 870-1086 Get Directions Write a Review

NPPES record last updated: April 23, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Apr 23, 2026, Dec 15, 2020, Dec 3, 2020 (3 updates tracked since 2020).

About Mary Crumbliss Msn, Cpnp-pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MARY CRUMBLISS MSN, CPNP-PC (NPI 1144825415) is an individual nurse practitioner in Johns Creek, Georgia, licensed in Georgia (RN298923) and active in the NPI registry since December 2020. She is enrolled in Medicare PECOS and maintains a secondary practice location in Ringgold.

NPPES Registry Identity

NPI1144825415
Entity TypeIndividualFemale
Primary Taxonomy363L00000X
Provider Legal NameMARY CRUMBLISSCredential: MSN, CPNP-PC
Location Address10710 MEDLOCK BRIDGE RD STE 250Johns Creek, GA 30097-1999
Mailing Address10710 Medlock Bridge Rd Ste 250Johns Creek, GA 30097-1999 · (770) 870-1085 · Fax (770) 870-1086
Phone(770) 870-1085
Fax(770) 870-1086
Sole ProprietorNo
Enumeration DateDecember 3, 2020
Last NPPES UpdateApril 23, 20263 updates tracked since enumeration
NPPES CertifiedApril 23, 2026
✔ NPI 1144825415 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
License✔ Licensed in GA · RN298923
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
Also ListedNurse Practitioner · PediatricsTaxonomy 363LP0200X · License APN0000028490 (TN)
10710 MEDLOCK BRIDGE RD STE 250, Johns Creek, GA 30097
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Secondary Practice Location 1

Location 1388 Fox Trot TrlRinggold, GA 30736-7367 · Phone (423) 838-3300

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mary Crumbliss Msn, Cpnp-pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Mary Crumbliss reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Urgent Care For Children, PLLC
96 mi
Pediatrics
5207 HIGHWAY 153
Hixson, TN 37343
  • Reassigned Medicare billing, Tennessee enrollment
  • 26 clinicians in this Medicare group
NPI 1205434420 (205) 848-2273

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30097 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$88.06 typical visit price
range $56.84 – $172.43
Typical copayment $22.01 (range $14.21 – $43.10)
Most-billed visit code 99203
Established Patient
$100.20 typical visit price
range $18.22 – $140.40
Typical copayment $25.05 (range $4.55 – $35.10)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MEADOW PEDIATRICS, PLLC
Pediatrics
10710 MEDLOCK BRIDGE RD STE 250
JOHNS CREEK, GA 30097
Gwinnett County (310) 707-8359

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mary Crumbliss's NPI number?

The NPI number for Mary Crumbliss is 1144825415. It was assigned to this individual provider in the NPPES registry on December 3, 2020.

Where is Mary Crumbliss located?

Mary Crumbliss practices at 10710 Medlock Bridge Rd Ste 250, Johns Creek, GA 30097. The listed phone number is (770) 870-1085.

What is Mary Crumbliss's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Mary Crumbliss enrolled in Medicare?

Yes. Mary Crumbliss is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Mary Crumbliss's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Mary Crumbliss reassigns Medicare benefits to Urgent Care For Children, PLLC (Hixson, TN). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Mary Crumbliss's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Mary Crumbliss accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama and Ambetter of North Carolina and 2 other insurers list Mary Crumbliss as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Mary Crumbliss was last updated on April 23, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.