Individual provider Active NPI

John Louis, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Augusta, GA
National Provider Identifier
1124747357
Registry record updated Aug 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
RN283509 Issued in GA
Practice address
3405 Mike Padgett Hwy
Augusta, GA 30906-3815
Phone
(706) 792-7021
NPI assigned
Aug 23, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2022

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 RN283509 GA Primary

Addresses

Primary practice location

3405 Mike Padgett Hwy
Augusta, GA 30906-3815

Mailing address

4110 Knollcrest Cir N
Martinez, GA 30907-1635
Phone (706) 951-9216

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
I20240201001912 GA Practitioner - Nurse Practitioner 0042663403 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Augusta Psychiatry and Therapy Associates, LLCGroup PAC ID 4789105172, 6 clinicians

Practice addresses (Care Compare)

3405 Mike Padgett Hwy
Augusta, GA 30906-3815
Phone (705) 790-2030

3665 Wheeler Rd
Suite 1a
Augusta, GA 30909-6596
Phone (706) 250-3902

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN283509GAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Department of Behavioral Health and Developmental Disabilities Current Accepting new patients
Evolve Managed Care Solutions CurrentSince Nov 22, 2024 Accepting new patients
Augusta Psychiatry and Therapy Associates, LLC CurrentSince Jan 1, 2025 Accepting new patients
Department of Behavioral Health & Developmental Disabilities, Ga CurrentSince Oct 1, 2023 Accepting new patients
Department of Behavioral Health and Developmental Disabilities CurrentSince Oct 1, 2023 Accepting new patients

Locations

3405 Old Savannah Rd
Augusta, GA 30906
Phone (705) 790-2030

3665 Wheeler Rd
Ste 1A
Augusta, GA 30909
Phone (706) 250-3902

519 Blackburn Dr
Ste 523
Martinez, GA 30907
Phone (706) 267-0793

Organizations & group practices 5

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": "1661212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661212800000",
    "number": "1124747357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4110 KNOLLCREST CIR N",
            "city": "MARTINEZ",
            "state": "GA",
            "postal_code": "309071635",
            "telephone_number": "706-951-9216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3405 MIKE PADGETT HWY",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309063815",
            "telephone_number": "706-792-7021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOUIS",
        "first_name": "JOHN",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-08-23",
        "last_updated": "2022-08-23",
        "certification_date": "2022-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "GA",
            "license": "RN283509",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, GA

Sources for this page

Verify at the official NPI Registry.