Individual provider Active NPI

Amy Mahaley, NP

  • Family Nurse Practitioner
  • Dacula, GA
National Provider Identifier
1386099604
Registry record updated Oct 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN169605 Issued in GA
Practice address
2850 Hog Mountain Rd Ste 101
Dacula, GA 30019-5935
Phone
(770) 614-7170
Fax
(770) 614-8233
NPI assigned
Apr 25, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 9, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN169605 GA Primary

Addresses

Primary practice location

2850 Hog Mountain Rd Ste 101
Dacula, GA 30019-5935

Mailing address

2850 Hog Mountain Rd Ste 101
Dacula, GA 30019-5935
Phone (770) 614-7170

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address amy.mahaley.p2@direct.gmg.nextgenshare.com Direct

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
I20160628001342 GA Practitioner - Nurse Practitioner 9537450218 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Gwinnett Physician Group, LLCGroup PAC ID 9133211139, 112 clinicians

Practice addresses (Care Compare)

1000 Medical Ctr Blvd
Lawrenceville, GA 30046-7694
Phone (678) 312-4321

2850 Hog Mountain Rd
Dacula, GA 30019-5935

Hospital & facility affiliations

  • Northside Hospital Gwinnett Hospital, Lawrenceville, GA, CCN 110087

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN169605GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Gwinnett Physician Group, LLC CurrentSince Jun 1, 2018 Accepting new patients

Locations

2850 Hog Mountain Rd
Ste 101
Dacula, GA 30019
Phone (404) 446-1940

601 Old Norcross Rd
Ste A
Lawrenceville, GA 30046
Phone 7702843150458

1000 Medical Center Blvd
Lawrenceville, GA 30046
Phone (678) 312-3356

Organizations & group practices 1

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": "1461542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759968000000",
    "number": "1386099604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2850 HOG MOUNTAIN RD STE 101",
            "city": "DACULA",
            "state": "GA",
            "postal_code": "300195935",
            "telephone_number": "770-614-7170",
            "fax_number": "770-614-8233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2850 HOG MOUNTAIN RD STE 101",
            "city": "DACULA",
            "state": "GA",
            "postal_code": "300195935",
            "telephone_number": "770-614-7170",
            "fax_number": "770-614-8233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHALEY",
        "first_name": "AMY",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-04-25",
        "last_updated": "2025-10-09",
        "certification_date": "2025-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN169605",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "amy.mahaley.p2@direct.gmg.nextgenshare.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct Edge",
            "address_1": "601 Old Norcross Rd Ste A",
            "city": "Lawrenceville",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300464311",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Dacula, GA

Sources for this page

Verify at the official NPI Registry.