MARY S. BATES, RPH — NPI 1104979459 (Licensed & Credentialed Pharmacist in WINDER, GA)

CMS-1500 Box 24J / 33a • NPI

1104979459

Type 1 Individual Rendering/Ordering

HIPAA NUCC Taxonomy • CMS Code

183500000X

Licensed & Credentialed Pharmacist

Box 32 Service Location & ZIP+4

17 MONROE HWY, WINDER, GA, 30680-7186

✓ 9-Digit EDI 837 ZIP+4 (30680-7186)

Practice Phone & Referral Fax

(770) 307-2906

Direct NPPES Verification Line

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1104979459 (MARY S. BATES, RPH) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

This practitioner does not currently appear in the CMS individual Order & Referring PECOS file (may practice in pediatrics, commercial-only networks, or hospital-employed settings).

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1104979459` (NPI-1 Individual Practitioner)
Provider / Legal Name	MARY S. BATES, RPH
Plain-English Specialty	Licensed & Credentialed Pharmacist NUCC Code: `183500000X` (Pharmacist)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	17 MONROE HWY, WINDER, GA, 30680-7186
Practice Telephone / Fax	Tel: (770) 307-2906
Administrative Mailing Address	4095 MOUNT CARMEL CHURCH RD, MONROE, GA, 30655-5183
Enumeration & Last Sync	Enumerated: 2007-01-19 \| CMS Record Updated: 2007-07-08

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

17 MONROE HWY, WINDER, GA, 30680-7186

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Plain-English Taxonomy & CMS Crosswalk (183500000X)

What Does Taxonomy Code 183500000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 183500000X translates to:
"Licensed & Credentialed Pharmacist"

CMS-1500 Medicare Specialty Crosswalk: Standard HIPAA X12N 837P / CMS-1500
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Pharmacist for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (MARY S. BATES, RPH)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`183500000X` — Pharmacist Plain English: Licensed & Credentialed Pharmacist	State: GA \| License: `RPH010198` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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MARY S. BATES, RPH (NPI #1104979459)