Individual provider Active NPI

Tammy Henson, PMHNP

  • Psychiatry Physician
  • Toccoa, GA
National Provider Identifier
1114782638
Registry record updated Feb 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
RN129204 Issued in GA
Practice address
1763 Fernside Dr
Toccoa, GA 30577-8095
Phone
(706) 282-4542
NPI assigned
Feb 14, 2024
Last updated
Feb 14, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X RN129204 GA Primary

Addresses

Primary practice location

1763 Fernside Dr
Toccoa, GA 30577-8095

Mailing address

627 Trestle Ridge Rd
Toccoa, GA 30577-9060
Phone (706) 244-1252

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
I20240409003659 GA Practitioner - Nurse Practitioner 2567800576 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Georgia Mountains Community ServicesGroup PAC ID 8921094400, 27 clinicians

Practice addresses (Care Compare)

150 A Johnson St
Dahlonega, GA 30533-0501
Phone (706) 864-6822

4331 Thurmon Tanner Rd
Flowery Branch, GA 30542-2829
Phone (678) 513-5700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Georgia Mountains Community Services CurrentSince Feb 12, 2024 Accepting new patients
Avita Community Partners PastSince Feb 18, 2024 Accepting new patients

Locations

76 Hunt Martin St
Ste A
Blairsville, GA 30512
Phone (706) 745-5911

150A Johnson St
Dahlonega, GA 30533
Phone (706) 864-6822

1763 Fernside Dr
Toccoa, GA 30577
Phone (706) 282-4542

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/avitapartners/r4/

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.

NPI Registry JSON

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

{
    "created_epoch": "1707868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707868800000",
    "number": "1114782638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "627 TRESTLE RIDGE RD",
            "city": "TOCCOA",
            "state": "GA",
            "postal_code": "305779060",
            "telephone_number": "706-244-1252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1763 FERNSIDE DR",
            "city": "TOCCOA",
            "state": "GA",
            "postal_code": "305778095",
            "telephone_number": "706-282-4542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENSON",
        "first_name": "TAMMY",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-14",
        "last_updated": "2024-02-14",
        "certification_date": "2024-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "GA",
            "license": "RN129204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Toccoa, GA

Sources for this page

Verify at the official NPI Registry.