Individual provider Active NPI

Amanda Chenault

  • Psychiatric/Mental Health Nurse Practitioner
  • Cartersville, GA
National Provider Identifier
1467141119
Registry record updated Apr 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
RN225526 Issued in GA
Practice address
650 Joe Frank Harris Pkwy SE
Cartersville, GA 30120-3962
Phone
(706) 229-7332
Fax
(706) 270-5111
NPI assigned
May 8, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 12, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X RN225526 GA Primary
Psychiatric/Mental Health Registered Nurse 163WP0808X 225526 GA

Addresses

Primary practice location

650 Joe Frank Harris Pkwy SE
Cartersville, GA 30120-3962

Mailing address

650 Joe Frank Harris Parkway
Cartersville, GA 30120
Phone (866) 938-7785

Other practice location 1

231 W. Hancock Street
Milledgeville, GA 31061
Phone (770) 500-6840

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
I20231109001426 GA Practitioner - Nurse Practitioner 3971950163 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

650 Joe Frank Harris Pkwy SE
Cartersville, GA 30120-3962
Phone (770) 387-3538

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
225526GAMDPsychiatric/Mental Health Registered Nurse
RN225526GAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Highland Rivers CSB CurrentSince Sep 19, 2023 Accepting new patients
Highland Rivers Community Service Board CurrentSince Sep 19, 2023 Accepting new patients

Locations

191 Lamar Haley Pkwy
Canton, GA 30114
Phone (770) 704-1600

650 Joe Frank Harris Pkwy SE
Cartersville, GA 30120
Phone (770) 387-3538

1503 N Tibbs Rd
Dalton, GA 30720
Phone (706) 229-4507

Organizations & group practices 2

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": "1683504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744416000000",
    "number": "1467141119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 JOE FRANK HARRIS PARKWAY",
            "city": "CARTERSVILLE",
            "state": "GA",
            "postal_code": "30120",
            "telephone_number": "866-938-7785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 JOE FRANK HARRIS PKWY SE",
            "city": "CARTERSVILLE",
            "state": "GA",
            "postal_code": "301203962",
            "telephone_number": "706-229-7332",
            "fax_number": "706-270-5111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "231 W. Hancock Street",
            "address_purpose": "LOCATION",
            "city": "Milledgeville",
            "state": "GA",
            "postal_code": "31061",
            "country_code": "US",
            "telephone_number": "770-500-6840",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHENAULT",
        "first_name": "AMANDA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-05-08",
        "last_updated": "2025-04-12",
        "certification_date": "2025-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "GA",
            "license": "RN225526",
            "primary": true
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "GA",
            "license": "225526",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cartersville, GA

Sources for this page

Verify at the official NPI Registry.