Individual provider Active NPI

Andrea Lynne Maloy, FNP

  • Family Nurse Practitioner
  • Bishop, GA
National Provider Identifier
1447845243
Registry record updated Dec 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN203531 Issued in GA
Practice address
3450 New High Shoals Rd
Bishop, GA 30621-1305
Phone
(706) 769-7738
NPI assigned
Mar 3, 2021
Last updated
Dec 4, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 4, 2024

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 RN203531 GA Primary

Addresses

Primary practice location

3450 New High Shoals Rd
Bishop, GA 30621-1305

Mailing address

1140 Derby LN
Bogart, GA 30622-5911

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
I20210504001320 GA Practitioner - Nurse Practitioner 3971912999 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Georgia Mso LLC CurrentSince Apr 15, 2025 Accepting new patients
Hardy Renew Wellness,LLC CurrentSince Sep 28, 2024 Accepting new patients

Locations

1640 Powers Ferry Rd SE
Bldg 15
Marietta, GA 30067
Phone (770) 722-9595

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": "1614729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733270400000",
    "number": "1447845243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1140 DERBY LN",
            "city": "BOGART",
            "state": "GA",
            "postal_code": "306225911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3450 NEW HIGH SHOALS RD",
            "city": "BISHOP",
            "state": "GA",
            "postal_code": "306211305",
            "telephone_number": "706-769-7738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALOY",
        "first_name": "ANDREA",
        "middle_name": "LYNNE",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-03",
        "last_updated": "2024-12-04",
        "certification_date": "2024-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN203531",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bishop, GA

Sources for this page

Verify at the official NPI Registry.