Individual provider Active NPI

Ronald Soelimto, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Cumming, GA
National Provider Identifier
1194252783
Registry record updated Jun 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN-NP293788 Issued in GA
Practice address
5965 Parkway North Blvd Ste C
Cumming, GA 30040-1431
Phone
(770) 886-5700
Fax
(770) 886-0404
NPI assigned
May 15, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN-NP293788 GA Primary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 337116 AZ
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN-281552 MT

Addresses

Primary practice location

5965 Parkway North Blvd Ste C
Cumming, GA 30040-1431

Mailing address

5965 Parkway North Blvd Ste C
Cumming, GA 30040-1431
Phone (770) 886-5700

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
I20211111001321 GA Practitioner - Nurse Practitioner 5991069106 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Personal Recovery Network LLCGroup PAC ID 5092611384, 612 clinicians

Practice addresses (Care Compare)

5965 Pkwy N Blvd
Suite a
Cumming, GA 30040-1431
Phone (770) 886-5700

Hospital & facility affiliations

  • Union General Hospital Hospital, Blairsville, GA, CCN 110051

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN-NP293788GAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
North Georgia Medicine LLC CurrentSince Oct 1, 2021 Accepting new patients
Personal Recovery Network LLC CurrentSince Feb 12, 2024 Accepting new patients

Locations

346 Deep South Farm Rd
#A
Blairsville, GA 30512
Phone (706) 745-9417

4799 Blue Ridge Dr
Ste 104
Blue Ridge, GA 30513
Phone (706) 492-3200

5965 Parkway North Blvd
Ste C
Cumming, GA 30040
Phone (770) 475-8014

5965 Parkway North Blvd
Ste A
Cumming, GA 30040
Phone (470) 239-4846

250 Corporate Center Ct
Stockbridge, GA 30281
Phone (770) 954-8685

Interoperability endpoints

  • Direct secure messaging: lifestancehealth.ronaldsoelimto@124220.advancedmd-direct.com

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 and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1494806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782691200000",
    "number": "1194252783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5965 PARKWAY NORTH BLVD STE C",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300401431",
            "telephone_number": "770-886-5700",
            "fax_number": "770-886-0404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5965 PARKWAY NORTH BLVD STE C",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300401431",
            "telephone_number": "770-886-5700",
            "fax_number": "770-886-0404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOELIMTO",
        "first_name": "RONALD",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-15",
        "last_updated": "2026-06-29",
        "certification_date": "2026-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "GA",
            "license": "APRN-NP293788",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "337116",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MT",
            "license": "APRN-281552",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cumming, GA

Sources for this page

Verify at the official NPI Registry.