Individual provider Active NPI

Miyesha A Cheeks, DNP, MSN, FNP-BC

  • Nurse Practitioner
  • Lawrenceville, GA
National Provider Identifier
1316005523
Registry record updated Jun 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN146277 Issued in GA
Practice address
250 Langley Dr Ste 1101
Lawrenceville, GA 30046-6932
Phone
(770) 954-5997
NPI assigned
Dec 4, 2006
Last updated
Jun 29, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN146277 GA Primary

Addresses

Primary practice location

250 Langley Dr Ste 1101
Lawrenceville, GA 30046-6932

Mailing address

1419 Turtlebrook LN
Lawrenceville, GA 30043-6972
Phone (917) 853-5056

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
I20070416000262 GA Practitioner - Nurse Practitioner 9032214333 Reassigns benefits to 1 organization
Practice locations: Lawrenceville, GA

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Duke University School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

250 Langley Dr
Suite 1101
Lawrenceville, GA 30046-6932
Phone (770) 954-5997

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN146277GAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
To Our Shores, Inc CurrentSince Jun 16, 2022 Accepting new patients
To Our Shores, Inc CurrentSince Jun 16, 2022 Accepting new patients
Rediclinic LLC Past Accepting new patients

Locations

250 Langley Dr
Ste 1101
Lawrenceville, GA 30046
Phone (770) 954-5997

Interoperability endpoints

  • Direct secure messaging: miyesha.cheeks.1@29590.direct.athenahealth.com

Organizations & group practices 3

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": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624924800000",
    "number": "1316005523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1419 TURTLEBROOK LN",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300436972",
            "telephone_number": "917-853-5056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 LANGLEY DR STE 1101",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300466932",
            "telephone_number": "770-954-5997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHEEKS",
        "first_name": "MIYESHA",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DNP, MSN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-04",
        "last_updated": "2021-06-29",
        "certification_date": "2021-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN146277",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceville, GA

Sources for this page

Verify at the official NPI Registry.