Alicia Marie Conn, FNP, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

000000 Issued in GA

Practice address

6205 Fox Run Cir
Blackshear, GA 31516-5322

Phone

(912) 670-0808

NPI assigned

Jan 3, 2017

Last updated

Apr 14, 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

Other identifiers 1

Other names 1

• Ms. Alicia Marie Thrift Former name

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, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Theoria MedicalGroup PAC ID 5395098339, 317 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

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.

• Theoria Medical

  • Internal Medicine Physician
  • Novi, MI
  • NPI 1609362375

  GA

  Medicare reassignment Care Compare group NPD
• Empower Wellness, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Waycross, GA
  • NPI 1386238723
  Medicare reassignment NPD
• Gateway Community Service Board

  • Community/Behavioral Health Agency
  • Brunswick, GA
  • NPI 1558478214
  Medicare reassignment NPD
• Hospital Authority of Jeff Davis County Georgia

  dba Jeff Davis Hospital

  • Critical Access Hospital
  • Hazlehurst, GA
  • NPI 1912902263
  Medicare reassignment NPD
• Mayo Clinic Health System in Waycross, Inc.

  • Multi-Specialty Clinic/Center
  • Waycross, GA
  • NPI 1154745982
  Medicare reassignment NPD
• Gateway Behavioral Health Services

  • Mental Illness Community Based Residential Treatment Facility
  • Brunswick, GA
  • NPI 1124254321
  NPD
• Hospital Authority of Jeff Davis County Georgia

  dba Jeff Davis Behavioral Health Services

  • Psychiatric Hospital Unit
  • Hazlehurst, GA
  • NPI 1023593498
  NPD
• Hospital Authority of Jeff Davis County Georgia

  dba Family Healthcare Connections

  • Internal Medicine Physician
  • Hazlehurst, GA
  • NPI 1528874518
  NPD
• Integrated Regional Laboratories Pathology Services, LLC

  dba IRL Pathology Services

  • Anatomic Pathology & Clinical Pathology Physician
  • Atlantis, FL
  • NPI 1942526298
  NPD
• Tift Regional Health System Inc

  dba WorkSmart Occupational Medicine

  • Clinic/Center
  • Tifton, GA
  • NPI 1003980996
  NPD (past)

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

{
    "created_epoch": "1483401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744588800000",
    "number": "1538604368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6205 FOX RUN CIR",
            "city": "BLACKSHEAR",
            "state": "GA",
            "postal_code": "315165322",
            "telephone_number": "912-670-0808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6205 FOX RUN CIR",
            "city": "BLACKSHEAR",
            "state": "GA",
            "postal_code": "315165322",
            "telephone_number": "912-670-0808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONN",
        "first_name": "ALICIA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "FNP, PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-01-03",
        "last_updated": "2025-04-14",
        "certification_date": "2025-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN230326",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "GA",
            "license": "000000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003254260A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALICIA",
            "last_name": "THRIFT",
            "middle_name": "MARIE",
            "prefix": "MS.",
            "credential": "FNP-C, PMHNP-BC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Chris Ray Carbaugh, PHARM.D.
• Jenna Rose Carver
• Stephanie Lyne Chadwick, FNP
• Angel Lee Chancey, RN
• Theresa Sasser Clements
• Jeffrey P. Davenport, M.D.
• Thomas W Davis, M.D.
• DB Wellness LLC
• Susan Deen, NP
• Dr Kim Bradley Hood DMD PC

• Psychiatric/Mental Health Nurse Practitioner in Blackshear, GA
• Providers in Blackshear, 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 Apr 14, 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.