Andriea L. Mimbs, NP-C

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

RN135482 Issued in GA

Practice address

308 Coliseum Dr Ste 120
Macon, GA 31217-3859

Phone

(478) 745-6130

Fax

(478) 745-4443

NPI assigned

Jan 7, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• NSH Cancer Institute Professional Services G, LLC

  • Hematology & Oncology Physician
  • Sandy Springs, GA
  • NPI 1144571381
  Medicare reassignment NPD
• NSH Cancer Institute Professional Services G LLC

  • Durable Medical Equipment & Medical Supplies
  • Blue Ridge, GA
  • NPI 1629329792
  NPD
• NSH Cancer Institute Professional Services G, LLC

  • Hematology & Oncology Physician
  • Atlanta, GA
  • NPI 1124379284
  NPD
• Northside Imaging LLC

  • Diagnostic Radiology Physician
  • Warner Robins, GA
  • NPI 1316394976
  NPD (past)

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

{
    "created_epoch": "1420588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1154719540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1835 SAVOY DR STE 300",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303411071",
            "telephone_number": "678-288-9555",
            "fax_number": "678-288-9556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "308 COLISEUM DR STE 120",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312173859",
            "telephone_number": "478-745-6130",
            "fax_number": "478-745-4443"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "206 Hospital Dr",
            "address_2": "suite b",
            "address_purpose": "LOCATION",
            "city": "Dublin",
            "state": "GA",
            "postal_code": "310212560",
            "country_code": "US",
            "telephone_number": "478-272-8266",
            "fax_number": "478-272-7552",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MIMBS",
        "first_name": "ANDRIEA",
        "middle_name": "L.",
        "name_prefix": "Ms.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-07",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "135482",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN135482",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Betsy Mills, LPC, SAP, CEAP
• Daniel Russell Mills, LMSW
• Jeremy Tobias Mills, RN
• Kathryn Mills
• Michael Vernon Mills, M.D
• Jeffrey Dover Mimbs, MD
• Kayla Lashay Mims
• Schuyler Kathleen Mims, M.D.
• Tashanda Kasey Mims
• Ma Lourdes Blas Mina, MD

• Nurse Practitioner in Macon, GA
• Providers in Macon, GA by specialty
• Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.