Individual provider Active NPI

Alesia Rochale Traeye Nix, DNP, FNP-C

  • Family Nurse Practitioner
  • Valdosta, GA
National Provider Identifier
1891095451
Registry record updated Nov 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
GAA-NP001077 Issued in GA
Practice address
3841 Coventry Dr
Valdosta, GA 31605-7968
Phone
(352) 246-5917
NPI assigned
Oct 29, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X
Family Nurse Practitioner 363LF0000X APRN9336508 FL
Family Nurse Practitioner 363LF0000X GAA-NP001077 GA Primary

Addresses

Primary practice location

3841 Coventry Dr
Valdosta, GA 31605-7968

Mailing address

3841 Coventry Dr
Valdosta, GA 31605-7968
Phone (352) 246-5917

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
I20230113000381 GA Practitioner - Nurse Practitioner 0648641449 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN9336508FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Monogram Health Professional Services PC Family CurrentSince Nov 20, 2024 Accepting new patients
Monogram Health Professional Services PC Family CurrentSince Nov 20, 2024 Accepting new patients
Behavioral Health Crisis Center PastSince Dec 1, 2022 Accepting new patients

Locations

3350 Riverwood Pkwy SE
Ste 1900
Atlanta, GA 30339
Phone (404) 277-2167

5410 Maryland Way
Ste 400
Brentwood, TN 37027

Interoperability endpoints

  • Direct secure messaging: alesia.nix.1@22854.direct.athenahealth.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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1288310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732060800000",
    "number": "1891095451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3841 COVENTRY DR",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316057968",
            "telephone_number": "352-246-5917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3841 COVENTRY DR",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316057968",
            "telephone_number": "352-246-5917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIX",
        "first_name": "ALESIA",
        "middle_name": "ROCHALE TRAEYE",
        "name_prefix": "Miss",
        "credential": "DNP, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-29",
        "last_updated": "2024-11-20",
        "certification_date": "2024-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN9336508",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "GAA-NP001077",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valdosta, GA

Sources for this page

Verify at the official NPI Registry.