Individual provider Active NPI

Amy Lord Mitton, NP-C

  • Family Nurse Practitioner
  • Dahlonega, GA
National Provider Identifier
1528370426
Registry record updated Jul 12, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN118764 Issued in GA
Practice address
82 College Circle
Dahlonega, GA 30597
Phone
(706) 867-2713
NPI assigned
Jul 8, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2010

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 RN118764 GA Primary

Addresses

Primary practice location

82 College Circle
Dahlonega, GA 30597

Mailing address

3320 Cove Rd
Jasper, GA 30143-5005
Phone (770) 894-5575

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
I20141024001717 GA Practitioner - Nurse Practitioner 7810118346 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Internal Medicine Associates of Jasper, PC CurrentSince Oct 1, 2014 Accepting new patients

Locations

51 Gordon Rd
Ste 201
Jasper, GA 30143
Phone 70669297684002

51 Gordon Rd
#201
Jasper, GA 30143

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.

NPI Registry JSON

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

{
    "created_epoch": "1278547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278892800000",
    "number": "1528370426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3320 COVE RD",
            "city": "JASPER",
            "state": "GA",
            "postal_code": "301435005",
            "telephone_number": "770-894-5575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "82 COLLEGE CIRCLE",
            "city": "DAHLONEGA",
            "state": "GA",
            "postal_code": "30597",
            "telephone_number": "706-867-2713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITTON",
        "first_name": "AMY",
        "middle_name": "LORD",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-08",
        "last_updated": "2010-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN118764",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dahlonega, GA

Sources for this page

Verify at the official NPI Registry.