Individual provider Active NPI

Chelsea Nicole Overby, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Grovetown, GA
National Provider Identifier
1700664372
Registry record updated Oct 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN-NP254308 Issued in GA
Practice address
4039 Gateway Blvd
Grovetown, GA 30813-3389
Phone
(706) 498-9570
Fax
(678) 369-5762
NPI assigned
Sep 15, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2025

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 APRN-NP254308 GA Primary
Registered Nurse 163W00000X RN254308 GA

Addresses

Primary practice location

4039 Gateway Blvd
Grovetown, GA 30813-3389

Mailing address

4039 Gateway Blvd
Grovetown, GA 30813-3389
Phone (706) 498-9570

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, SC2 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
I20240312001442 GA Practitioner - Nurse Practitioner 3173969276 Reassigns benefits to 2 organizations
I20250716003211 SC Practitioner - Nurse Practitioner 3173969276 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Personal Recovery Network LLCGroup PAC ID 5092611384, 612 clinicians

Practice addresses (Care Compare)

4039 Gateway Blvd
Grovetown, GA 30813-3389
Phone (706) 498-9570

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APRN-NP254308GAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
SC House Calls Inc CurrentSince Feb 19, 2024 Accepting new patients
Personal Recovery Network LLC CurrentSince Jul 31, 2025 Accepting new patients
SC House Calls Inc CurrentSince Feb 19, 2024 Accepting new patients

Locations

624 Ellis St
Augusta, GA 30901

1109 Medical Center Dr
Ste 2A
Augusta, GA 30909
Phone (706) 901-4242

4039 Gateway Blvd
Grovetown, GA 30813
Phone (706) 498-9570

250 Corporate Center Ct
Stockbridge, GA 30281
Phone (770) 954-8685

111 Doctor Cir
Columbia, SC 29203
Phone (803) 730-8910

1053 Center St
West Columbia, SC 29169
Phone (803) 454-0365

Interoperability endpoints

  • Direct secure messaging: lifestancehealth.chelseaoverby@124220.advancedmd-direct.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1694736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761523200000",
    "number": "1700664372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4039 GATEWAY BLVD",
            "city": "GROVETOWN",
            "state": "GA",
            "postal_code": "308133389",
            "telephone_number": "706-498-9570",
            "fax_number": "678-369-5762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4039 GATEWAY BLVD",
            "city": "GROVETOWN",
            "state": "GA",
            "postal_code": "308133389",
            "telephone_number": "706-498-9570",
            "fax_number": "678-369-5762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OVERBY",
        "first_name": "CHELSEA",
        "middle_name": "NICOLE",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-15",
        "last_updated": "2025-10-27",
        "certification_date": "2025-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "GA",
            "license": "APRN-NP254308",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GA",
            "license": "RN254308",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grovetown, GA

Sources for this page

Verify at the official NPI Registry.