Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jack Anthony Miceli, NP-C

Individual provider Nurse Practitioner · NPI 1821623232

Jack Anthony Miceli, NP-C is a Nurse Practitioner in Rome, Georgia. Qualified in 2019, 7 years ago. Practices with Harbin Clinic LLC, a 254-clinician group and accepts Medicare assignment. Licensed in Georgia.

Years since qualifying
7
Licensed in
GA
In the registry since
2020
What do these letters mean?
NP-C — Nurse Practitioner, Certified
A nurse practitioner certified by the AANP.

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Practice location Address checks out

1825 Martha Berry Blvd NW
Rome, GA 30165-1625
Phone: (762) 235-1470
Fax: (706) 238-8081
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence RN242971 (GA)

Record details

NPI number1821623232
Entity typeIndividual (Type 1)
GenderMale
Credentials NP-C
Sole proprietorNo
NPI enumeratedMarch 5, 2020
Last updated in NPPESOctober 24, 2023
Certification dateOctober 24, 2023
Mailing address221 Technology Pkwy Nw, Rome, GA 30165-1369

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Harbin Clinic Llc — 254 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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