MARYLOU LACOMB-DAVIS CPNP-PC - NPI 1881946374 - Nurse Practitioner in Augusta, GA

Q: What is the provider's specialty?

The provider's specialty is Nurse Practitioner with taxonomy code 363LP0200X and a focus in Pediatrics.

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About Marylou Lacomb-davis Cpnp-pc NPPES

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

MARYLOU LACOMB-DAVIS CPNP-PC (NPI 1881946374) is an individual pediatrics provider in Augusta, Georgia, licensed in Georgia (RN250156) and active in the NPI registry since October 2012. She is enrolled in Medicare PECOS and maintains a secondary practice location in White Plains.

NPPES Registry Identity

NPI1881946374

Entity TypeIndividualFemale

Primary Taxonomy363LP0200X

Provider Legal NameMARYLOU LACOMB-DAVISCredential: CPNP-PC

Location Address987 SAINT SEBASTIAN WAYAugusta, GA 30912-2613

Mailing Address987 Saint Sebastian WayAugusta, GA 30912-2613 · (706) 721-9847

Phone(706) 721-9847

Sole ProprietorNo

Enumeration DateOctober 8, 2012

Last NPPES UpdateJanuary 28, 2021

NPPES CertifiedJanuary 28, 2021

✔ NPI 1881946374 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · PediatricsPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP0200X

Licenses✔ Licensed in GA · RN250156✔ Licensed in VA · 0024164874✔ Licensed in DC · RN960827✔ Licensed in MD · R207282✔ Licensed in MD · AC001077

987 SAINT SEBASTIAN WAY, Augusta, GA 30912

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Secondary Practice Location 1

Location 14255 Altamont Place, Suite 301White Plains, MD 20695 · Phone (301) 645-1781 · Fax (301) 374-9237

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Marylou Lacomb-davis 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30912 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 7

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

DR. SHARON M BENNETT DNP, APRN, BC

Registered Nurse (Psychiatric/Mental Health)

987 SAINT SEBASTIAN WAY, EC 1500
AUGUSTA, GA 30912

Richmond County (706) 721-1195

AU HEALTH PROFESSIONS ASSOCIATES, INC.

Prosthetic/Orthotic Supplier

987 SAINT SEBASTIAN WAY, EC 1500
AUGUSTA, GA 30912

Richmond County (706) 721-1225

MR. DANIEL HAYNIA APRN

Nurse Practitioner (Adult Health)