Michelle Denise McMickin

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

197311 Issued in GA

Practice address

52 Woodmont Dr
Lagrange, GA 30241-7703

Phone

(229) 347-7215

NPI assigned

Apr 26, 2019

Last updated

Apr 26, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA, AL2 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

Specialty

Nurse Practitioner

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Urgencare, LLCGroup PAC ID 7113250325, 18 clinicians

Peachtree Immediate Care FP, LLCGroup PAC ID 3274559323, 328 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Peachtree Immediate Care FP, LLC

  • Family Medicine Physician
  • Hiram, GA
  • NPI 1437194156
  Medicare reassignment Care Compare group
• Urgencare, LLC

  • Urgent Care Clinic/Center
  • Lagrange, GA
  • NPI 1598223844

  AL

  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1556236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556236800000",
    "number": "1184288920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "52 WOODMONT DR",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302417703",
            "telephone_number": "229-347-7215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "52 WOODMONT DR",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302417703",
            "telephone_number": "229-347-7215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMICKIN",
        "first_name": "MICHELLE",
        "middle_name": "DENISE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-26",
        "last_updated": "2019-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "197311",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tammy McGhee
• Wanda McGill
• Joshua D. McGinty, DPT
• Diane L McGowan, M.D.
• James P McGowan, M.D.
• Darrell L McMullen Sr., CASE MANAGER
• Keisha McNeill, MS, LPC
• Med Ventures MRI, LLC
• Medical Care of Lagrange, LLC
• Medventures Physical Therapy, LLC

• Family Nurse Practitioner in Lagrange, GA
• Providers in Lagrange, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2019; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.