Individual provider Active NPI

Andrea Kirsten Owes, ARNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Dacula, GA
National Provider Identifier
1558860064
Registry record updated Aug 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
26NJ00944000 Issued in NJ
Practice address
673 Secret Garden LN
Dacula, GA 30019-1764
Phone
(470) 542-5276
NPI assigned
Feb 10, 2018
Last updated
Aug 16, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 16, 2026

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 26NJ00944000 NJ Primary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X F402335 NY

Addresses

Primary practice location

673 Secret Garden LN
Dacula, GA 30019-1764

Mailing address

673 Secret Garden LN
Dacula, GA 30019-1764
Phone (470) 542-5276

Other practice location 1

625 Broad St Ste 240
Newark, NJ 07102-4417
Phone (973) 991-7849

Other practice location 2

455 Philip Blvd Ste 130
Lawrenceville, GA 30046-8768
Phone (404) 321-6111

Other identifiers 2

IdentifierTypeStateIssuer
05240428MedicaidNY
87-4725132MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, GA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20220816003371 NY Practitioner - Nurse Practitioner 8325475429 Reassigns benefits to 1 organization
I20260402002448 GA Practitioner - Nurse Practitioner 8325475429 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

66 E Flagler St
Miami, FL 33130-1807

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F402335NYMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Genpsych Livingston PastSince Dec 9, 2019 Accepting new patients
August Aichhorn Center for Adolescent Residential Care, Inc. Past Accepting new patients

Organizations & group practices 3

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": "1518220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786838400000",
    "number": "1558860064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "673 SECRET GARDEN LN",
            "city": "DACULA",
            "state": "GA",
            "postal_code": "300191764",
            "telephone_number": "470-542-5276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "673 SECRET GARDEN LN",
            "city": "DACULA",
            "state": "GA",
            "postal_code": "300191764",
            "telephone_number": "470-542-5276"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "625 Broad St Ste 240",
            "address_purpose": "LOCATION",
            "city": "Newark",
            "state": "NJ",
            "postal_code": "071024417",
            "country_code": "US",
            "telephone_number": "973-991-7849",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "455 Philip Blvd Ste 130",
            "address_purpose": "LOCATION",
            "city": "Lawrenceville",
            "state": "GA",
            "postal_code": "300468768",
            "country_code": "US",
            "telephone_number": "404-321-6111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OWES",
        "first_name": "ANDREA",
        "middle_name": "KIRSTEN",
        "name_prefix": "Ms.",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-02-10",
        "last_updated": "2026-08-16",
        "certification_date": "2026-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "26NJ00944000",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "F402335",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05240428",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "87-4725132",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dacula, GA

Sources for this page

Verify at the official NPI Registry.