Individual provider Active NPI

Meghan S Dinnerman, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Watkinsville, GA
National Provider Identifier
1689403701
Registry record updated Jul 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
RN299677 Issued in GA
Practice address
1361 Jennings Mill Rd
Ste 201
Watkinsville, GA 30677
Phone
(706) 316-1908
NPI assigned
Jul 29, 2024
Last updated
Jul 29, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2024

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 RN299677 GA Primary

Addresses

Primary practice location

1361 Jennings Mill Rd
Ste 201
Watkinsville, GA 30677

Mailing address

253 Sidney Lanier Ave
Athens, GA 30607
Phone (706) 206-7620

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

18670 Graphics Dr
Suite 200
Tinley Park, IL 60477-4605

709 Breedlove Dr
Monroe, GA 30655-2055

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN299677GAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Georgia TRD Clinic, LLC CurrentSince Aug 4, 2024 Accepting new patients
Athens Behavioral Medicine CurrentSince Aug 4, 2024 Accepting new patients

Locations

1361 Jennings Mill Rd
Ste 201
Watkinsville, GA 30677
Phone (706) 316-1908

Organizations & group practices 2

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": "1722211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722211200000",
    "number": "1689403701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "253 SIDNEY LANIER AVE",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "30607",
            "telephone_number": "706-206-7620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1361 JENNINGS MILL RD",
            "address_2": "STE 201",
            "city": "WATKINSVILLE",
            "state": "GA",
            "postal_code": "30677",
            "telephone_number": "706-316-1908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DINNERMAN",
        "first_name": "MEGHAN",
        "middle_name": "S",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-29",
        "last_updated": "2024-07-29",
        "certification_date": "2024-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "GA",
            "license": "RN299677",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Watkinsville, GA

Sources for this page

Verify at the official NPI Registry.