NPI age
10 years
Enumerated 2015-11-18
● Active
Type 1 · Individual
Dixie Mayberry, PA
Mayberry is 1 of 50 physician assistant providers in Marietta and 1 of 640 in Georgia.
Primary specialty
Physician Assistant
Plus 1 subspecialty
Licensed in
GA, SC
2 states
Status
Active
No deactivations on record
Last NPPES update
2024-02-26
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org
How this provider compares
Across 640 active physician assistant providers in Georgia.
NPI age
10 years
↓ 3 yr below median (13 yr)
State licenses
2 states
Top 89% — 10% of peers are multi-state
Subspecialties
0
37% of peers hold subspecialties
NPI lifetime · 2015 → 2026
2015-11Enumerated in NPPES
2015
2026
Where they practice
Practice location
818 Church St Ne
Marietta, GA 300608981
Mailing address
818 Church St Ne
Marietta, GA 300608981
Additional practice locations
1 secondary location on file with NPPES.
Location 2
160 Academy Ave
Greenwood, SC 296463808
Specialties
-
Physician Assistant PrimaryDefinition to come...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 05 (SC) | 2450PA |
Multi-state credentialing: Licensed in 2 states. Useful context for credentialers building cross-state provider networks.
Practice context
Part of a multi-provider practice. 13 other active providers share this practice address in NPPES.
Recently enumerated nearby: 1 new physician assistant provider has been added in Marietta in the last 180 days.
See all →
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Check the state license is currently active.State licensing boards publish current status; NPPES does not.
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