Individual provider Active NPI

Sandy Anderson Coleman

  • Family Nurse Practitioner
  • Ellijay, GA
National Provider Identifier
1447667183
Registry record updated Mar 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN123413 Issued in GA
Practice address
526 Maddox Dr Ste 101
Ellijay, GA 30540-5566
Phone
(850) 233-3376
Fax
(850) 522-8354
NPI assigned
Jul 15, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 4, 2026

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 RN123413 GA Primary

Addresses

Primary practice location

526 Maddox Dr Ste 101
Ellijay, GA 30540-5566

Mailing address

2505 Harrison Ave
Panama City, FL 32405-4464
Phone (850) 233-3376

Other practice location 1

2550 Windy Hill Rd SE
Marietta, GA 30067-8665
Phone (850) 233-3376

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
I20160718001025 GA Practitioner - Nurse Practitioner 0648562322 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dermatology Specialists of Georgia LLCGroup PAC ID 5799770624, 16 clinicians

Practice addresses (Care Compare)

1605 Whitesville St
Lagrange, GA 30240-5903
Phone (877) 231-3376

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN123413GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
West Georgia Dermatology PC Current Accepting new patients
Southeastern Dermatology Group PA CurrentSince Sep 1, 2019 Accepting new patients
Dermatology Specialists of Georgia, LLC CurrentSince Sep 15, 2022 Accepting new patients

Locations

2505 Harrison Ave
Panama City, FL 32405
Phone 85023333762619

4360 Chamblee Dunwoody Rd
Ste 260
Atlanta, GA 30341
Phone (770) 452-5667

526 Maddox Dr
Ste 101
Ellijay, GA 30540
Phone (706) 635-6325

1605 Whitesville St
Lagrange, GA 30240
Phone (706) 548-3019

2550 Windy Hill Rd SE
Ste 220
Marietta, GA 30067
Phone (770) 952-2100

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1405382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772582400000",
    "number": "1447667183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2505 HARRISON AVE",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324054464",
            "telephone_number": "850-233-3376",
            "fax_number": "850-522-8354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "526 MADDOX DR STE 101",
            "city": "ELLIJAY",
            "state": "GA",
            "postal_code": "305405566",
            "telephone_number": "850-233-3376",
            "fax_number": "850-522-8354"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2550 Windy Hill Rd SE",
            "address_purpose": "LOCATION",
            "city": "Marietta",
            "state": "GA",
            "postal_code": "300678665",
            "country_code": "US",
            "telephone_number": "850-233-3376",
            "fax_number": "850-522-8354",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COLEMAN",
        "first_name": "SANDY",
        "middle_name": "ANDERSON",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-15",
        "last_updated": "2026-03-04",
        "certification_date": "2026-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN123413",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellijay, GA

Sources for this page

Verify at the official NPI Registry.