Individual provider Active NPI

Nicole Teresa Hood, FNP

  • Family Nurse Practitioner
  • Canton, GA
National Provider Identifier
1811970098
Registry record updated Feb 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN124002 Issued in GA
Practice address
6120 Hickory Flat Hwy
Canton, GA 30115-7252
Phone
(678) 793-8698
NPI assigned
Nov 22, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN124002 GA Primary

Addresses

Primary practice location

6120 Hickory Flat Hwy
Canton, GA 30115-7252

Mailing address

2220 Lansdowne Dr
Canton, GA 30115-8400
Phone (678) 793-8698

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
I20051221000108 GA Practitioner - Nurse Practitioner 2769404532 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Chronic Disease Management of Georgia LLCGroup PAC ID 7618306721, 76 clinicians

Practice addresses (Care Compare)

704 Breedlove Dr
Suite a
Monroe, GA 30655-2054
Phone (888) 772-0076

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Chronic Disease Management of Georgia, LLC CurrentSince Jul 19, 2024 Accepting new patients

Locations

704 Breedlove Dr
#A
Monroe, GA 30655
Phone (888) 772-0076

Organizations & group practices 1

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": "1132617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486339200000",
    "number": "1811970098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2220 LANSDOWNE DR",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301158400",
            "telephone_number": "678-793-8698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6120 HICKORY FLAT HWY",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301157252",
            "telephone_number": "678-793-8698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOOD",
        "first_name": "NICOLE",
        "middle_name": "TERESA",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-22",
        "last_updated": "2017-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN124002",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, GA

Sources for this page

Verify at the official NPI Registry.