Active NPI
Vickie Simmons, FNP
- Family Nurse Practitioner
- Dahlonega, GA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- RN077582
- Practice address
- 134 Ansley Dr Ste 400
Dahlonega, GA 30533 - Phone
- (706) 864-1580
- Fax
- (770) 219-9561
- NPI assigned
- Mar 23, 2006
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | R077582 | GA | |
| Internal Medicine Physician | 207R00000X | RN077582 | GA | |
| Family Nurse Practitioner | 363LF0000X | RN077582 | GA | Primary |
Addresses
Primary practice location
134 Ansley Dr Ste 400
Dahlonega, GA 30533
Mailing address
PO Box 742616
Atlanta, GA 30374-2616
Phone (770) 219-8420
Other practice location 1
59 Tipton Dr
Dahlonega, GA 30533-1603
Phone (706) 864-4012
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
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070315000115 | GA | Practitioner - Nurse Practitioner | 3779686522 | Reassigns benefits to 1 organization |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Nurse Practitioner, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R077582 | GA | MD | Family Medicine Physician |
| RN077582 | GA | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northeast Georgia Physicians Group Inc | Family Medicine | Current | Accepting new patients |
| Georgia Heart Institute LLC | Past | Accepting new patients | |
| Northeast Georgia Medical Center, Inc. | Past | Accepting new patients | |
| Allergy and ENT of Ga | Family Medicine | Past | Accepting new patients |
Locations
1515 River Pl
Ste 100
Braselton, GA 30517
Phone (770) 848-6195
4445 S Lee St
Ste 100
Buford, GA 30518
Phone (770) 848-5200
134 Ansley Dr
Ste 400
Dahlonega, GA 30533
Phone (706) 864-1580
227 Mountain Dr
Dahlonega, GA 30533
Phone (706) 864-6136
597 S Enota Dr NE
Gainesville, GA 30501
Phone (770) 219-8275
950 S Enota Dr NE
Ste A
Gainesville, GA 30501
Phone (678) 450-8969
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.
-
- Family Medicine Physician
- Gainesville, GA
- NPI 1891745212
Family Medicine, GA
-
- Cardiovascular Disease Physician
- Gainesville, GA
- NPI 1477976520
-
- General Acute Care Hospital
- Gainesville, GA
- NPI 1427055821
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143072000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1530576000000",
"number": "1932169299",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 742616",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303742616",
"telephone_number": "770-219-8420",
"fax_number": "770-219-8440"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "134 ANSLEY DR STE 400",
"city": "DAHLONEGA",
"state": "GA",
"postal_code": "30533",
"telephone_number": "706-864-1580",
"fax_number": "770-219-9561"
}
],
"practiceLocations": [
{
"address_1": "59 Tipton Dr",
"address_purpose": "LOCATION",
"city": "Dahlonega",
"state": "GA",
"postal_code": "305331603",
"country_code": "US",
"telephone_number": "706-864-4012",
"fax_number": "706-864-4029",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SIMMONS",
"first_name": "VICKIE",
"name_prefix": "Ms.",
"credential": "FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-03-23",
"last_updated": "2018-07-03",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "GA",
"license": "R077582",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "GA",
"license": "RN077582",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "GA",
"license": "RN077582",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Dahlonega, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2018; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.