Individual provider Active NPI

Amy Lynn Chaffin, APRN, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • St Simons Island, GA
National Provider Identifier
1558048777
Registry record updated Jun 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
RN298928 Issued in GA
Practice address
2927 Demere Rd
Saint Simons Island, GA 31522-1620
Phone
(912) 638-1999
NPI assigned
Jun 29, 2023
Last updated
Jun 29, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X RN298928 GA Primary

Addresses

Primary practice location

2927 Demere Rd
Saint Simons Island, GA 31522-1620

Mailing address

320 Palm Club Cir
Brunswick, GA 31525-2051
Phone (740) 703-2313

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
I20230928003880 GA Practitioner - Nurse Practitioner 8628422318 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Unison Behavioral HealthGroup PAC ID 7517852247, 19 clinicians
SGMP Southland, LLCGroup PAC ID 1153563770, 28 clinicians

Practice addresses (Care Compare)

1007 Mary St
Waycross, GA 31503-3823
Phone (912) 285-6142

2927 Demere Rd
St Simons Is, GA 31522-1620
Phone (229) 236-0831

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Unison Behavioral Health CurrentSince Feb 28, 2024 Accepting new patients
SGMP Southland LLC CurrentSince Aug 15, 2023 Accepting new patients
Unison Behavioral Health CurrentSince Feb 28, 2024 Accepting new patients
Choice Family Medicine, PC Current Accepting new patients

Locations

2927 Demere Rd
St Simons Island, GA 31522
Phone (912) 638-1999

201 Woodrow Wilson Dr
Valdosta, GA 31602
Phone (229) 241-0041

1007 Mary St
Waycross, GA 31503
Phone (912) 284-2547

Organizations & group practices 4

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": "1687996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687996800000",
    "number": "1558048777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 PALM CLUB CIR",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315252051",
            "telephone_number": "740-703-2313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2927 DEMERE RD",
            "city": "SAINT SIMONS ISLAND",
            "state": "GA",
            "postal_code": "315221620",
            "telephone_number": "912-638-1999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAFFIN",
        "first_name": "AMY",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "APRN, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-29",
        "last_updated": "2023-06-29",
        "certification_date": "2023-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "GA",
            "license": "RN298928",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Simons Island, GA

Sources for this page

Verify at the official NPI Registry.