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MARY MINTER NP-C
NPI 1275919771
Nurse Practitioner - Family in Vidalia, GA

Active since August 06, 2015PECOS Enrolled
414 LUGENIA DR, VIDALIA, GA 30474(912) 537-9355(912) 537-7038 Get Directions Write a Review

NPPES record last updated: August 6, 2015. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Mary Minter Np-c NPPES

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

MARY MINTER NP-C (NPI 1275919771) is an individual family provider in Vidalia, Georgia, licensed in Georgia (RN216867) and active in the NPI registry since August 2015. She is enrolled in Medicare PECOS and is a graduate of Other (2015).

NPPES Registry Identity

NPI1275919771
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameMARY MINTERCredential: NP-C
Location Address414 LUGENIA DRVidalia, GA 30474-7210
Mailing Address1720 Nicole LnVidalia, GA 30474-5640 · (404) 272-6813
Phone(912) 537-9355
Fax(912) 537-7038
Sole ProprietorNo
Medical School CMSOtherGraduated 2015
Enumeration DateAugust 6, 2015
✔ NPI 1275919771 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in GA · RN216867
414 LUGENIA DR, Vidalia, GA 30474
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mary Minter Np-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID5698160273
PECOS Enrollment IDI20220317000944
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 Minter reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Brightmoor Hospice, LLC
135 mi
Hospice Care, Community Based
3247 NEWNAN RD
Griffin, GA 30223
  • Reassigned Medicare billing, Georgia enrollment
  • 11 clinicians in this Medicare group
NPI 1275520751 (770) 467-9930

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 30474 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
$83.23 typical visit price
range $53.31 – $164.04
Typical copayment $20.80 (range $13.32 – $41.01)
Most-billed visit code 99203
Established Patient
$94.84 typical visit price
range $16.68 – $133.24
Typical copayment $23.71 (range $4.17 – $33.31)
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 4

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

PREFERRED LABS OF VIDALIA LLC
Clinical Medical Laboratory
414 LUGENIA DR
VIDALIA, GA 30474
Toombs County (912) 386-7117
MRS. KELLY WHITE WALL FNP-C
Nurse Practitioner (Family)
414 LUGENIA DR
VIDALIA, GA 30474
Toombs County (912) 537-9355
LAURA H WHITE PMHNP, FNP-C
Nurse Practitioner (Psychiatric/Mental Health)
414 LUGENIA DR
VIDALIA, GA 30474
Toombs County (912) 537-9355
SWAYAMPRABHA S TYAGI MD
Pediatrics
414 LUGENIA DR
VIDALIA, GA 30474
Toombs County (912) 537-9355

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 Minter's NPI number?

The NPI number for Mary Minter is 1275919771. It was assigned to this individual provider in the NPPES registry on August 6, 2015.

Where is Mary Minter located?

Mary Minter practices at 414 Lugenia Dr, Vidalia, GA 30474. The listed phone number is (912) 537-9355.

What is Mary Minter's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Mary Minter enrolled in Medicare?

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

Which organization bills Medicare for Mary Minter's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Mary Minter reassigns Medicare benefits to Brightmoor Hospice, LLC (Griffin, GA). 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 Minter's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Mary Minter was last updated on August 6, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years 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.