Individual provider Active NPI

Anson Chin

  • Psychiatric/Mental Health Nurse Practitioner
  • Villa Rica, GA
National Provider Identifier
1033911136
Registry record updated Oct 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN-NP309560 Issued in GA
Practice address
20 Herrell Rd
Villa Rica, GA 30180-5527
Phone
(770) 812-3283
NPI assigned
Mar 27, 2025
Last updated
Oct 10, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN-NP309560 GA Primary

Addresses

Primary practice location

20 Herrell Rd
Villa Rica, GA 30180-5527

Mailing address

96 Wellington Walk
Douglasville, GA 30134-6364
Phone (786) 916-1537

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250403003790 GA Practitioner - Nurse Practitioner 6608390380 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
May accept Medicare assignment
Group practices
TMC-Behavioral Health of West GeorgiaGroup PAC ID 2163714635, 37 clinicians

Practice addresses (Care Compare)

101 Quartz Dr
Suite 103B
Villa Rica, GA 30180-3201
Phone (770) 812-3580

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN-NP309560GAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hamilton Physician Group Inc CurrentSince Nov 1, 2025 Accepting new patients
TMC-Behavioral Health of West Georgia CurrentSince Apr 21, 2025 Accepting new patients
Hamilton Medical Center, Inc. CurrentSince Nov 1, 2025 Accepting new patients

Locations

100 Greenway Blvd
Ste C
Carrollton, GA 30117
Phone (770) 838-8710

101 Doctors Dr
Carrollton, GA 30117
Phone (770) 812-8863

1200 Memorial Dr
Dalton, GA 30720
Phone (706) 272-6115

101 Quartz Dr
Ste 103B
Villa Rica, GA 30180
Phone (770) 812-3580

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1743033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760054400000",
    "number": "1033911136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "96 WELLINGTON WALK",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301346364",
            "telephone_number": "786-916-1537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 HERRELL RD",
            "city": "VILLA RICA",
            "state": "GA",
            "postal_code": "301805527",
            "telephone_number": "770-812-3283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHIN",
        "first_name": "ANSON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-03-27",
        "last_updated": "2025-10-10",
        "certification_date": "2025-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "GA",
            "license": "APRN-NP309560",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Villa Rica, GA

Sources for this page

Verify at the official NPI Registry.