Nicole Anderson, MSN, APRN, NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN280911 Issued in GA

Practice address

14205 Highway 92 Ste 101
Woodstock, GA 30188-7138

Phone

(678) 293-7854

Fax

(770) 591-7573

NPI assigned

Jan 23, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Wellstar Medical Group LLCGroup PAC ID 6709065402, 3,059 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: nanderson534108@directwellstar.org
• Direct secure messaging: nicole.anderson.1@6806.direct.athenahealth.com

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.

• Wellstar Medical Group, LLC

  • Family Medicine Physician
  • Kennesaw, GA
  • NPI 1558664003

  GA

  Medicare reassignment Care Compare group NPD
• Wellstar Medical Group, LLC

  • Multi-Specialty Clinic/Center
  • Marietta, GA
  • NPI 1275992240
  Care Compare group NPD
• Hope First Investments

  • Pharmacy
  • Atlanta, GA
  • NPI 1861114977
  NPD
• The Good Samaritan Health Center, Inc.

  • Primary Care Clinic/Center
  • Atlanta, GA
  • NPI 1629254008
  NPD

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

{
    "created_epoch": "1579737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702512000000",
    "number": "1568092047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14205 HIGHWAY 92 STE 101",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301887138",
            "telephone_number": "678-293-7854",
            "fax_number": "770-591-7573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14205 HIGHWAY 92 STE 101",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301887138",
            "telephone_number": "678-293-7854",
            "fax_number": "770-591-7573"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1015 Donald Lee Hollowell Pkwy NW",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303186653",
            "country_code": "US",
            "telephone_number": "404-523-6571",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "NICOLE",
        "credential": "MSN, APRN, NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-23",
        "last_updated": "2023-12-14",
        "certification_date": "2023-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN280911",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nanderson534108@directwellstar.org",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "14205 Highway 92 Ste 101",
            "city": "Woodstock",
            "state": "GA",
            "country_code": "US",
            "postal_code": "301887138",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Samaneh Amelrahattalab
• Mark Allan Amos, D.C., D.A.C.N.B.
• Douglas A. Anania, O.D.
• Alan Dennis Anderson, D.C.
• Murray J Anderson, DMD
• Shanice V Anderson
• Liska M Andu, DDS
• Olive Aneno, LCSW
• Lisa Marie Anthony, MS, LAT, ATC
• Semhare Anthony

• All providers in Woodstock, GA
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2023; 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.