Individual provider Active NPI

Anyta Hicks-Williams, AGNP-C, PMHNP-BC

  • Psychiatry Physician
  • Atlanta, GA
National Provider Identifier
1104367465
Registry record updated Sep 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
GAA-NP000275 Issued in GA
Practice address
1720 Peachtree St NW Ste 510
Atlanta, GA 30309-2462
Phone
(850) 313-4616
Fax
(619) 329-8933
NPI assigned
Mar 19, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2024

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X GAA-NP000275 GA
Geriatric Psychiatry Physician 2084P0805X GAA-NP000275 GA
Adult Health Nurse Practitioner 363LA2200X APRN11010204 FL
Gerontology Nurse Practitioner 363LG0600X GAA-NP000275 GA
Gerontology Nurse Practitioner 363LG0600X APRN11010204 FL
Psychiatry Physician 2084P0800X GAA-NP000275 GA Primary

Addresses

Primary practice location

1720 Peachtree St NW Ste 510
Atlanta, GA 30309-2462

Mailing address

PO Box 1132
Pensacola, FL 32591-1132
Phone (850) 313-4616

Other practice location 1

101 W Main St
Pensacola, FL 32502-5711
Phone (850) 313-4616

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, GA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210201001011 FL Practitioner - Nurse Practitioner 4183991201 Reassigns benefits to 1 organization
I20220208001831 GA Practitioner - Nurse Practitioner 4183991201 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2330 Scenic Hwy S
Suite 307
Snellville, GA 30078-3115
Phone (770) 985-9990

3601 Pebble LN
Milton, FL 32583-2301
Phone (850) 313-4616

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
GAA-NP000275GAMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Jody Amazon PC Geriatric Psychiatry CurrentSince Sep 16, 2024 Accepting new patients

Locations

2160 Fountain Dr
Ste 220
Snellville, GA 30078
Phone (678) 336-9102

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1489881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726617600000",
    "number": "1104367465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1132",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325911132",
            "telephone_number": "850-313-4616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1720 PEACHTREE ST NW STE 510",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303092462",
            "telephone_number": "850-313-4616",
            "fax_number": "619-329-8933"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 W Main St",
            "address_purpose": "LOCATION",
            "city": "Pensacola",
            "state": "FL",
            "postal_code": "325025711",
            "country_code": "US",
            "telephone_number": "850-313-4616",
            "fax_number": "619-329-8933",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HICKS-WILLIAMS",
        "first_name": "ANYTA",
        "name_prefix": "Dr.",
        "credential": "AGNP-C, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-19",
        "last_updated": "2024-09-18",
        "certification_date": "2024-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "GA",
            "license": "GAA-NP000275",
            "primary": false
        },
        {
            "code": "2084P0805X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Geriatric Psychiatry",
            "state": "GA",
            "license": "GAA-NP000275",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "APRN11010204",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "GA",
            "license": "GAA-NP000275",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "FL",
            "license": "APRN11010204",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "GA",
            "license": "GAA-NP000275",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.