Individual provider Active NPI

Vickie Simmons, FNP

  • Family Nurse Practitioner
  • Dahlonega, GA
National Provider Identifier
1932169299
Registry record updated Jul 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN077582 Issued in GA
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

Updated by the provider on Jul 3, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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

LicenseStateTypeSpecialty
R077582GAMDFamily Medicine Physician
RN077582GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Georgia Physicians Group Inc Family Medicine CurrentSince May 1, 2018 Accepting new patients
Georgia Heart Institute LLC PastSince Jan 8, 2018 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.

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

Verify at the official NPI Registry.