Individual provider Active NPI

Simone Marie Anderson

  • Family Nurse Practitioner
  • Atlanta, GA
National Provider Identifier
1184176356
Registry record updated Oct 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN-NP204839 Issued in GA
Practice address
1203 Cleveland Ave
Atlanta, GA 30344-3417
Phone
(404) 755-2291
NPI assigned
Nov 3, 2016
Last updated
Oct 29, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN-NP204839 GA Primary

Addresses

Primary practice location

1203 Cleveland Ave
Atlanta, GA 30344-3417

Mailing address

3426 Fieldstone Trce
Ellenwood, GA 30294-6307
Phone (678) 683-7988

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, FL, MS3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20170314001184 GA Practitioner - Nurse Practitioner 9739464777 Reassigns benefits to 5 organizations
I20260609000671 FL Practitioner - Nurse Practitioner 9739464777 Reassigns benefits to 1 organization
I20260609003139 MS Practitioner - Nurse Practitioner 9739464777 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

Practice addresses (Care Compare)

4055 Valley View LN
Suite 700
Dallas, TX 75244-4910

4055 Valley View LN
Suite 700
Dallas, TX 75244-5045

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APRN-NP204839GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Vision Medical Consulting, P.C. CurrentSince Dec 21, 2016 Accepting new patients
Ennoble HC DMV LLC CurrentSince Jan 2, 2024 Accepting new patients
Wellstreet of Georgia PC CurrentSince Oct 28, 2024 Accepting new patients
Resurgia Health Solutions PC CurrentSince Jul 26, 2023 Accepting new patients
Vision Medical Consulting, P.C. PastSince Aug 1, 2022 Accepting new patients

Locations

1100 Peachtree St NE
Ste 200
Atlanta, GA 30309
Phone (404) 445-5304

2292 Peachtree Rd NW
Atlanta, GA 30309
Phone (404) 382-9941

3715 Northside Pkwy NW
Bldg 2100
Atlanta, GA 30327
Phone (770) 938-1757

2002 Summit Blvd
Ste 300
Brookhaven, GA 30319
Phone (973) 241-1356

2 University Plz
Ste 204
Hackensack, NJ 07601
Phone (201) 564-0142

Interoperability endpoints

  • Direct secure messaging: sanderson@rhsl-ga.direct.office.nextgen.com

Organizations & group practices 7

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": "1478131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761696000000",
    "number": "1184176356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3426 FIELDSTONE TRCE",
            "city": "ELLENWOOD",
            "state": "GA",
            "postal_code": "302946307",
            "telephone_number": "678-683-7988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1203 CLEVELAND AVE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303443417",
            "telephone_number": "404-755-2291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "SIMONE",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-03",
        "last_updated": "2025-10-29",
        "certification_date": "2025-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "APRN-NP204839",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.