Anson Chin
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Villa Rica, GA
NPI 1033911136 · NPPES record last updated Oct 10, 2025
Key facts
- NPI
- 1033911136
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- APRN-NP309560 (GA)
- Practice address
- 20 Herrell Rd
Villa Rica, GA 30180-5527 - Phone
- (770) 812-3283
- NPI assigned
- Mar 27, 2025
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2024
- Medicare assignment
- May accept Medicare assignment
- Group practices
- TMC-Behavioral Health of West Georgia
Practice addresses (Care Compare)
101 Quartz Dr
Suite 103B
Villa Rica, GA 30180-3201
Phone (770) 812-3580
Hospital & facility affiliations
- Tanner Medical Center Villa Rica
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250403003790 | GA | Practitioner - Nurse Practitioner | 6608390380 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| APRN-NP309560 | GA | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hamilton Medical Center, Inc. | Current |
Accepting new patients | |
| TMC-Behavioral Health of West Georgia | Current |
Accepting new patients | |
| Hamilton Physician Group Inc | Current |
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
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | APRN-NP309560 | GA | Yes |
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
Other providers in Villa Rica, GA
- Latanya Renee Chapman
- Zeinab Charmchi
- Chattahoochee Healthcare LLC
- Muhammad Hasan Chauhan
- Robin Renee Childress-Rodriguez
- Stefanie Christopher
- Chrisyana Gedmyr Medcare LLC
- Clarity Counseling of West Georgia
- Candie Clark
- Bre'Yana Claxton
All providers in Villa Rica, GA · Psychiatric/Mental Health Nurse Practitioner in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 10, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.