Active NPI
Nancy C McInnis, PA
- Physician Assistant
- Atlanta, GA
National Provider Identifier
1871585158
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 001704
- Practice address
- 3715 Northside Pkwy NW Ste 2-100
Atlanta, GA 30327-2809 - Phone
- (404) 663-6130
- Fax
- (404) 289-5362
- NPI assigned
- Aug 22, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 001704 | GA | Primary |
Addresses
Primary practice location
3715 Northside Pkwy NW Ste 2-100
Atlanta, GA 30327-2809
Mailing address
3715 Northside Pkwy NW Ste 2-100
Atlanta, GA 30327-2809
Phone (404) 663-6130
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 1984
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
3715 Northside Pkwy NW
Building 2 100
Atlanta, GA 30327-2822
Phone (770) 938-1757
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 001704 | GA | MD | Psychologist |
Organizations & group practices 2
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.
-
- Family Medicine Physician
- Tucker, GA
- NPI 1073562922
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1124668800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1753660800000",
"number": "1871585158",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3715 NORTHSIDE PKWY NW STE 2-100",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303272809",
"telephone_number": "404-663-6130",
"fax_number": "404-289-5362"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3715 NORTHSIDE PKWY NW STE 2-100",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303272809",
"telephone_number": "404-663-6130",
"fax_number": "404-289-5362"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCINNIS",
"first_name": "NANCY",
"middle_name": "C",
"name_prefix": "Mrs.",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-08-22",
"last_updated": "2025-07-28",
"certification_date": "2025-07-28",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "GA",
"license": "001704",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Atlanta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.