Individual provider Active NPI

Amanda Rae Hinson, NP

  • Primary Care Nurse Practitioner
  • Stockbridge, GA
National Provider Identifier
1730628553
Registry record updated Jul 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
RN174971 Issued in GA
Practice address
7402 Davidson Cir W
Stockbridge, GA 30281
Phone
(770) 919-5238
NPI assigned
Feb 13, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X RN174971 GA Primary

Addresses

Primary practice location

7402 Davidson Cir W
Stockbridge, GA 30281

Mailing address

111 Moonlight CT
Jackson, GA 30233-3120
Phone (706) 463-3800

Other names 1

  • Amanda Rae Dover Former name

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
I20170404001626 GA Practitioner - Nurse Practitioner 8527344662 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Aga Professional Services LLCGroup PAC ID 3870768997, 175 clinicians

Practice addresses (Care Compare)

226 E College St
Suite B
Griffin, GA 30224-4348
Phone (678) 987-1490

Hospital & facility affiliations

  • Monroe County Hospital Hospital, Forsyth, GA, CCN 111318

Merit-based Incentive Payment System (MIPS)

Final score
74.39 of 100Reported as group
Quality
44.91
Promoting interoperability
98
Improvement activities
40
Cost
71.38

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN174971GAMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
South Atlanta Vascular Institute, LLC CurrentSince Jul 1, 2020 Accepting new patients

Locations

7402 Davidson Pkwy S
Stockbridge, GA 30281
Phone (770) 507-4070

7402 Davidson Pkwy S
Stockbridge, GA 30281
Phone (770) 507-0909

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/18188/brand/1/csg/1/fhir/r4
  • Direct secure messaging: amanda.hinson@ud.eclinicaldirectplus.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/BIJACD

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.

Hospital & facility affiliations 1

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": "1486944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594252800000",
    "number": "1730628553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 MOONLIGHT CT",
            "city": "JACKSON",
            "state": "GA",
            "postal_code": "302333120",
            "telephone_number": "706-463-3800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7402 DAVIDSON CIR W",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "30281",
            "telephone_number": "770-919-5238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HINSON",
        "first_name": "AMANDA",
        "middle_name": "RAE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-13",
        "last_updated": "2020-07-09",
        "certification_date": "2020-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "GA",
            "license": "RN174971",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "DOVER",
            "middle_name": "RAE",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Stockbridge, GA

Sources for this page

Verify at the official NPI Registry.