Individual provider Active NPI

Alexandra Maria Ackerman, NP

  • Nurse Practitioner
  • Newnan, GA
National Provider Identifier
1669100418
Registry record updated Jan 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN283458 Issued in GA
Practice address
110 Oak Hill Blvd Ste 200
Newnan, GA 30265-2313
Phone
(770) 304-0987
NPI assigned
Aug 10, 2022
Last updated
Jan 10, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X RN283458 GA
Nurse Practitioner 363L00000X RN283458 GA Primary

Addresses

Primary practice location

110 Oak Hill Blvd Ste 200
Newnan, GA 30265-2313

Mailing address

531 Witcher Rd
Newnan, GA 30263-4640
Phone (262) 758-1654

Other practice location 1

600 Celebrate Life Pkwy
Newnan, GA 30265-8001
Phone (770) 343-7692

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
I20220920001060 GA Practitioner - Nurse Practitioner 3274918750 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Piedmont Medical Care CorporationGroup PAC ID 6002802220, 368 clinicians

Practice addresses (Care Compare)

110 Oak Hill Blvd
Suite 200
Newnan, GA 30265-2313
Phone (770) 304-0987

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
79.74 of 100Reported as group
Quality
63.81
Promoting interoperability
100
Improvement activities
40
Cost
57.71

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN283458GAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
City of Hope Medical Group of Georgia LLC CurrentSince Sep 12, 2022 Accepting new patients
Piedmont Medical Care Corporation Family Medicine CurrentSince Dec 1, 2024 Accepting new patients
Piedmont Providers LLC PastSince Dec 1, 2024 Accepting new patients

Locations

105 Collier Rd NW
Ste 5020
Atlanta, GA 30309
Phone (404) 350-3860

110 Oak Hill Blvd
Ste 200
Newnan, GA 30265
Phone (770) 304-0987

600 Celebrate Life Pkwy
Newnan, GA 30265
Phone (404) 844-8334

62742 Collections Ctr Dr
Chicago, IL 60693

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1660089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736467200000",
    "number": "1669100418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "531 WITCHER RD",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302634640",
            "telephone_number": "262-758-1654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 OAK HILL BLVD STE 200",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302652313",
            "telephone_number": "770-304-0987"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "600 Celebrate Life Pkwy",
            "address_purpose": "LOCATION",
            "city": "Newnan",
            "state": "GA",
            "postal_code": "302658001",
            "country_code": "US",
            "telephone_number": "770-343-7692",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ACKERMAN",
        "first_name": "ALEXANDRA",
        "middle_name": "MARIA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-10",
        "last_updated": "2025-01-10",
        "certification_date": "2025-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "RN283458",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN283458",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newnan, GA

Sources for this page

Verify at the official NPI Registry.