Erica Minnion-Klyce, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN301375 Issued in GA

Practice address

1825 Rockbridge Rd Ste 15B
Stone Mountain, GA 30087-3306

Phone

(470) 444-3134

Fax

(470) 276-4370

NPI assigned

Dec 1, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL, GA, OH, NY4 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 4

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H3359

Interoperability endpoints

• Direct secure messaging: erica.minnionklyce@oakstreethealth.gwaydirect.com
• FHIR API: https://fhir-myrecord.cerner.com/r4/1a399bfe-f78b-4bd3-b22b-301d9fc9736a/

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.

• Oak Street Health of Georgia PC

  • Primary Care Clinic/Center
  • Stone Mountain, GA
  • NPI 1588258024

  Family

  Medicare reassignment NPD
• Oak Street Health of New York Medical Group PC

  • Primary Care Clinic/Center
  • Brooklyn, NY
  • NPI 1780209445

  Family

  Medicare reassignment NPD
• Oak Street Health Physicians Group, PC

  • Primary Care Clinic/Center
  • Chicago, IL
  • NPI 1083051643

  Family

  Medicare reassignment NPD
• Signify Health Medical Associates, PLLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1750845863

  GA, IL

  Medicare reassignment NPD
• Signify Health, LLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1689158487

  OH

  Medicare reassignment NPD
• Emk Services LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Tinley Park, IL
  • NPI 1255198271
  NPD Authorized official
• Qcpi-Villagemd, PC

  dba Village Medical

  • Family Medicine Physician
  • Atlanta, GA
  • NPI 1558872432
  NPD (past)
• Johnson Regional Medical Center

  • General Acute Care Hospital
  • Clarksville, AR
  • NPI 1134116049
  NPD (past)

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

{
    "created_epoch": "1512086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728864000000",
    "number": "1205340080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 740015",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303740015",
            "telephone_number": "312-733-9730",
            "fax_number": "312-929-0373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1825 ROCKBRIDGE RD STE 15B",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300873306",
            "telephone_number": "470-444-3134",
            "fax_number": "470-276-4370"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1263 Moreland Ave SE",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303163183",
            "country_code": "US",
            "telephone_number": "470-444-3137",
            "fax_number": "470-202-3003",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2732 Candler Rd",
            "address_purpose": "LOCATION",
            "city": "Decatur",
            "state": "GA",
            "postal_code": "300341410",
            "country_code": "US",
            "telephone_number": "470-444-3133",
            "fax_number": "470-276-4051",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1715 E 95th St",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606174708",
            "country_code": "US",
            "telephone_number": "773-768-4437",
            "fax_number": "773-564-3515",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3088 Washington Rd",
            "address_purpose": "LOCATION",
            "city": "East Point",
            "state": "GA",
            "postal_code": "303444566",
            "country_code": "US",
            "telephone_number": "470-444-3135",
            "fax_number": "404-777-9336",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7028 Highway 85",
            "address_purpose": "LOCATION",
            "city": "Riverdale",
            "state": "GA",
            "postal_code": "302742946",
            "country_code": "US",
            "telephone_number": "470-444-3136",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1631 Gordon Hwy Ste 17A",
            "address_purpose": "LOCATION",
            "city": "Augusta",
            "state": "GA",
            "postal_code": "309062229",
            "country_code": "US",
            "telephone_number": "706-261-0018",
            "fax_number": "762-257-7442",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "625 S Marietta Pkwy SE",
            "address_purpose": "LOCATION",
            "city": "Marietta",
            "state": "GA",
            "postal_code": "300602748",
            "country_code": "US",
            "telephone_number": "470-377-7228",
            "fax_number": "470-467-7583",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "677 Cascade Ave SW",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303102404",
            "country_code": "US",
            "telephone_number": "470-444-3143",
            "fax_number": "470-467-7469",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "455 Sutter Ave",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112128111",
            "country_code": "US",
            "telephone_number": "718-765-6550",
            "fax_number": "347-620-9739",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MINNION-KLYCE",
        "first_name": "ERICA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-01",
        "last_updated": "2024-10-14",
        "certification_date": "2024-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "355099",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209016926",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN301375",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "209016926",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Family Nurse Practitioner in Stone Mountain, GA
• Providers in Stone Mountain, 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 Oct 14, 2024; 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.