Individual provider Active NPI

Andrea Nimene, NP

  • Family Nurse Practitioner
  • Hiram, GA
National Provider Identifier
1861945610
Registry record updated May 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
174556 Issued in GA
Practice address
126 Enterprise Path
Hiram, GA 30141-2656
Phone
(678) 567-0920
NPI assigned
Jul 28, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2021

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 RN174556 GA
Family Nurse Practitioner 363LF0000X 174556 GA Primary

Addresses

Primary practice location

126 Enterprise Path
Hiram, GA 30141-2656

Mailing address

126 Enterprise Path
Hiram, GA 30141-2656
Phone (678) 567-0920

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, MA2 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
I20181027000195 GA Practitioner - Nurse Practitioner 4486907128 Reassigns benefits to 1 organization
I20240815001309 MA Practitioner - Nurse Practitioner 4486907128

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

6 Mathis Dr NW
Suite B
Rome, GA 30165-1242
Phone (706) 233-9023

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
174556GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Highland Rivers Community Service Board CurrentSince Jun 22, 2021 Accepting new patients
Highland Rivers CSB CurrentSince Apr 26, 2021 Accepting new patients
Highland Rivers CSB CurrentSince Apr 26, 2021 Accepting new patients

Locations

191 Lamar Haley Pkwy
Canton, GA 30114
Phone (770) 704-1600

1503 N Tibbs Rd
Dalton, GA 30720
Phone (706) 229-4507

126 Enterprise Path
Ste 206
Hiram, GA 30141
Phone (678) 567-0920

126 Enterprise Path
Hiram, GA 30141
Phone (678) 567-0920

6 Mathis Dr NW
Rome, GA 30165
Phone (706) 233-9023

6 Mathis Dr NW
Ste B
Rome, GA 30165
Phone (706) 233-9023

Interoperability endpoints

  • Direct secure messaging: nudayhealthservicesandreanimene@159043.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.

Hospital & facility affiliations 3

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": "1469664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621814400000",
    "number": "1861945610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "126 ENTERPRISE PATH",
            "city": "HIRAM",
            "state": "GA",
            "postal_code": "301412656",
            "telephone_number": "678-567-0920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "126 ENTERPRISE PATH",
            "city": "HIRAM",
            "state": "GA",
            "postal_code": "301412656",
            "telephone_number": "678-567-0920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIMENE",
        "first_name": "ANDREA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-28",
        "last_updated": "2021-05-24",
        "certification_date": "2021-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "GA",
            "license": "RN174556",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "174556",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hiram, GA

Sources for this page

Verify at the official NPI Registry.