Joshua Minich, APRN, RN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN248941 Issued in GA

Practice address

105 Walnut St
Montezuma, GA 31063-1902

Phone

(478) 472-4633

Fax

(478) 472-4637

NPI assigned

Feb 24, 2012

Reactivated

Jan 13, 2021

Last updated

Jun 13, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner, Registered Nurse

State licenses

Practice roles

Locations

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.

• River Edge Behavioral Health Center

  • Community/Behavioral Health Agency
  • Macon, GA
  • NPI 1174512966
  Medicare reassignment NPD
• Nelson T. Madrazo

  dba Sumter Pediatrics

  • Pediatric Nurse Practitioner
  • Montezuma, GA
  • NPI 1760534770
  NPD (past)
• Sumter Pediatrics LLC

  dba Sumter Pediatrics

  • Primary Care Clinic/Center
  • Leesburg, GA
  • NPI 1033502299
  NPD (past)

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

{
    "created_epoch": "1330041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655078400000",
    "number": "1346514221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 WALNUT ST",
            "city": "MONTEZUMA",
            "state": "GA",
            "postal_code": "310631902",
            "telephone_number": "478-472-4633",
            "fax_number": "478-472-4637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 WALNUT ST",
            "city": "MONTEZUMA",
            "state": "GA",
            "postal_code": "310631902",
            "telephone_number": "478-472-4633",
            "fax_number": "478-472-4637"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "175 Emery Hwy",
            "address_purpose": "LOCATION",
            "city": "Macon",
            "state": "GA",
            "postal_code": "312173692",
            "country_code": "US",
            "telephone_number": "478-803-7600",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "415 N Jackson St",
            "address_2": "PO DRAWER 1348",
            "address_purpose": "LOCATION",
            "city": "Americus",
            "state": "GA",
            "postal_code": "317093015",
            "country_code": "US",
            "telephone_number": "229-931-2504",
            "fax_number": "229-931-2474",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MINICH",
        "first_name": "JOSHUA",
        "credential": "APRN, RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-02-24",
        "last_updated": "2022-06-13",
        "certification_date": "2022-06-13",
        "deactivation_date": "2020-07-24",
        "reactivation_date": "2021-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN248941",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Macon County Medical Center, Inc Dba Flint River Community Hospital
• Macon County Medical Center, Inc.
• Demetria Anise McDonald
• Medicine Stop LLC (Medicine Stop II)
• Middle Flint Area Community Service Board
• Montezuma Health Care Center LLC (Montezuma Health and Rehabilitation)
• Montezuma Health Care Center LLC (Montezuma Health Care Center)
• Montezuma Health Care Center LLC (Montezuma Health Care Center)
• Montezuma Health Care Center LLC (Montezuma Health Care Center)
• Montezuma Health Care Center LLC (Montezuma Health Care Center)

• Family Nurse Practitioner in Montezuma, GA
• Providers in Montezuma, 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 Jun 13, 2022; 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.