Individual provider Active NPI

Angela Renee Addison, FNP-C

  • Family Nurse Practitioner
  • Thomasville, GA
National Provider Identifier
1093677569
Registry record updated Sep 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN-NP228718 Issued in GA
Practice address
919 S Broad St
Thomasville, GA 31792-6114
Phone
(229) 584-5400
NPI assigned
Dec 2, 2025
Last updated
Sep 13, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN11050543 FL
Family Nurse Practitioner 363LF0000X APRN-NP228718 GA Primary

Addresses

Primary practice location

919 S Broad St
Thomasville, GA 31792-6114

Mailing address

1819 W Tennessee St
Tallahassee, FL 32304-3356

Other practice location 1

1819 W Tennessee St
Tallahassee, FL 32304-3356
Phone (866) 389-2727

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
I20260107003793 GA Practitioner - Nurse Practitioner 2466938675 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

900 Cairo Rd
Thomasville, GA 31792-4255

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APRN11050543FLMDFamily Nurse Practitioner
APRN-NP228718GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Archbold Medical Group, Inc. CurrentSince Dec 1, 2025 Accepting new patients
Archbold Medical Group, Inc. CurrentSince Dec 1, 2025 Accepting new patients

Locations

100 Mimosa Dr
Thomasville, GA 31792
Phone (229) 226-9141

915 Gordon Ave
Thomasville, GA 31792
Phone (229) 228-8575

919 S Broad St
Thomasville, GA 31792
Phone (229) 228-2970

Organizations & group practices 2

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 2

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": "1764633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789257600000",
    "number": "1093677569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1819 W TENNESSEE ST",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323043356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "919 S BROAD ST",
            "city": "THOMASVILLE",
            "state": "GA",
            "postal_code": "317926114",
            "telephone_number": "229-584-5400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1819 W Tennessee St",
            "address_purpose": "LOCATION",
            "city": "Tallahassee",
            "state": "FL",
            "postal_code": "323043356",
            "country_code": "US",
            "telephone_number": "866-389-2727",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ADDISON",
        "first_name": "ANGELA",
        "middle_name": "RENEE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-12-02",
        "last_updated": "2026-09-13",
        "certification_date": "2026-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11050543",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "APRN-NP228718",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thomasville, GA

Sources for this page

Verify at the official NPI Registry.