Individual provider Active NPI

Melanie Charisse Hicks, PAA

  • Anesthesiologist Assistant
  • Atlanta, GA
National Provider Identifier
1720457930
Registry record updated Jun 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiologist AssistantTaxonomy code 367H00000X
License
7693 Issued in GA
Practice address
1405 Clifton Rd NE FL 3
Atlanta, GA 30322-1060
Phone
(404) 785-6670
Fax
(404) 785-1362
NPI assigned
Sep 17, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiologist Assistant 367H00000X 7693 GA Primary

Addresses

Primary practice location

1405 Clifton Rd NE FL 3
Atlanta, GA 30322-1060

Mailing address

1405 Clifton Rd NE FL 3
Atlanta, GA 30322-1060
Phone (404) 785-6670

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address choa@choa.gadirect.net

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in 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
I20210604000371 GA Practitioner - Physician Assistant 2062701006 Reassigns benefits to 1 organization
I20220907001178 GA Practitioner - Anesthesiology Assistant 2062701006 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7693GAMDAnesthesiologist Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Choa Multispecialty, LLC Current Accepting new patients
Egleston Pediatric Group Current Accepting new patients
Children's Anesthesia Services, LLC Anesthesiologist Assistant CurrentSince May 29, 2022 Accepting new patients

Locations

1364 Clifton Rd NE
Atlanta, GA 30322
Phone (404) 712-7100

1405 Clifton Rd NE
Fl 3
Atlanta, GA 30322
Phone (404) 785-6670

1405 Clifton Rd NE
Atlanta, GA 30322
Phone (404) 785-1112

2620 Satellite Blvd
Duluth, GA 30096
Phone (404) 785-8000

1001 Johnson Fy Rd NE
Sandy Springs, GA 30342
Phone (404) 785-2008

5445 Meridian Mark Rd
Ste 340
Sandy Springs, GA 30342
Phone (404) 785-5650

Organizations & group practices 4

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": "1442448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654473600000",
    "number": "1720457930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1405 CLIFTON RD NE FL 3",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303221060",
            "telephone_number": "404-785-6670",
            "fax_number": "404-785-1362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1405 CLIFTON RD NE FL 3",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303221060",
            "telephone_number": "404-785-6670",
            "fax_number": "404-785-1362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKS",
        "first_name": "MELANIE",
        "middle_name": "CHARISSE",
        "credential": "PAA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-17",
        "last_updated": "2022-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "GA",
            "license": "7693",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "choa@choa.gadirect.net",
            "affiliation": "N",
            "address_1": "1405 Clifton Rd NE Fl 3",
            "city": "Atlanta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "303221060",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.