Sidney Donette Medina

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

GAA-NP003512 Issued in GA

Practice address

2100 Comer Ave
Columbus, GA 31904-8725

Phone

(706) 596-5500

NPI assigned

Dec 13, 2022

Last updated

Sep 15, 2025By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

New Horizons Area MH Mr Sa ProgramGroup PAC ID 5698683431, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: sidney.medina.1@28492.direct.athenahealth.com

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.

• New Horizons Area MH Mr Sa Program

  dba New Horizons Community Service Board

  • Clinic/Center
  • Columbus, GA
  • NPI 1154315422
  Care Compare group
• Apex Medical Surgery Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Lagrange, GA
  • NPI 1508210378
  NPD (past)

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

{
    "created_epoch": "1670889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757894400000",
    "number": "1437861168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1150 NW 72ND AVE STE 455",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331261947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 COMER AVE",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319048725",
            "telephone_number": "706-596-5500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDINA",
        "first_name": "SIDNEY",
        "middle_name": "DONETTE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-12-13",
        "last_updated": "2025-09-15",
        "certification_date": "2025-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "GA",
            "license": "GAA-NP001222",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "GA",
            "license": "GAA-NP003512",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Medfund LLC (Horizon Columbus LLC)
• Medical Center Inc (Piedmont Pharmacy - Community Health,)
• Medical Center Inc (Piedmont Columbus Regional Midtown)
• Medical Center, Inc. (Regional Boutique)
• Medical Connections LLC
• Madonna Laree Medley
• Judith Louann Medlock, RPH
• Medmark Treatment Centers of Georgia, Inc. (Medmark Treatment Centers Columbus)
• Kenneth Andrew Medve, LCSW
• Jessica Joy Medzie

• Psychiatric/Mental Health Nurse Practitioner in Columbus, GA
• Providers in Columbus, GA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.