MARLIS JANE FABER DUNLAP (FNP-C) – Family Nurse Practitioner, NPI 1780620344
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
9,652 NURSE PRACTITIONER in GA
Provider Addresses for MARLIS JANE FABER DUNLAP (FNP-C)
CLARK-HOLDER CLINIC, P.A.
303 SMITH STREET
LAGRANGE, GA 30240
Phone: (706) 882-8831
Fax: (706) 812-4091
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 5 Open Payments records for all available years, with a total value of $110.
Total Amount is formed as General ($110) + Research ($0) + Ownership ($0) = $110.
Last reported payment date: 2023-12-22 • Largest payer in this snapshot: Medtronic, Inc. ($43).
Total Amount
$110
General + Research + Ownership
Payments
5
Total payment records
General Amount
$110
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-12-22
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Medtronic, Inc. | $43 |
| Merz North America, Inc. | $28 |
| Dexcom, Inc. | $23 |
| Novo Nordisk Inc | $15 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2008-11-20
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20081120000716 | I | Nurse Practitioner | GA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 336 | 169 | $0 |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 63 | 63 | $0 |
| G0008 | Administration of influenza virus vaccine | 19 | 18 | $0 |
| 90694 | Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage | 17 | 16 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 16 | 16 | $0 |
Insurance plans in this area (ZIP 30240)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Certified Registered Nurse Anesthetist (Crna) | TX | |
| Certified Registered Nurse Anesthetist (Crna) | GA | |
| Anesthesiology Assistant | GA | |
| Certified Registered Nurse Anesthetist (Crna) | GA | |
| Internal Medicine, Infectious Disease | GA | |
| - | GA | |
| - | GA | |
| Physician Assistant | GA | |
| Certified Registered Nurse Anesthetist (Crna) | FL | |
| N E U R O L O G Y | GA |
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