Individual provider Active NPI

Mia Eloisa Mison, N.P.

  • Psychiatric/Mental Health Nurse Practitioner
  • Suwanee, GA
National Provider Identifier
1548532203
Registry record updated Jun 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
RN212250 Issued in GA
Practice address
1490 Distribution Dr Ste 150
Suwanee, GA 30024-4916
Phone
(678) 263-3080
NPI assigned
Jan 27, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 18, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X RN212250 GA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X RN212250 GA Primary
Registered Nurse 163W00000X RN212250 GA

Addresses

Primary practice location

1490 Distribution Dr Ste 150
Suwanee, GA 30024-4916

Mailing address

1325 Satellite Blvd NW Ste 400
Suwanee, GA 30024-5299

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL http://www.psychprosga.com/ Direct

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
I20201203002122 GA Practitioner - Nurse Practitioner 8921419524 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Psychiatric Professionals of Georgia, LLC Psychiatry CurrentSince May 19, 2025 Accepting new patients

Locations

1325 Satellite Blvd NW
Ste 400
Suwanee, GA 30024
Phone (470) 713-0414

1490 Distribution Dr
Ste 150
Suwanee, GA 30024

Interoperability endpoints

  • Direct secure messaging: mia.mison.1@25899.direct.athenahealth.com

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": "1327622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750204800000",
    "number": "1548532203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1325 SATELLITE BLVD NW STE 400",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300245299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1490 DISTRIBUTION DR STE 150",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300244916",
            "telephone_number": "678-263-3080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MISON",
        "first_name": "MIA ELOISA",
        "credential": "N.P.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-01-27",
        "last_updated": "2025-06-18",
        "certification_date": "2025-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "GA",
            "license": "RN212250",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "GA",
            "license": "RN212250",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GA",
            "license": "RN212250",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "http://www.psychprosga.com/",
            "affiliation": "N",
            "endpointDescription": "Office",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1490 Distribution Dr Ste 150",
            "city": "Suwanee",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300244916",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Suwanee, GA

Sources for this page

Verify at the official NPI Registry.