Individual provider Active NPI

Ebony Nichole Story, PMHNP, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Harlem, GA
National Provider Identifier
1992599203
Registry record updated Jan 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
NP233862 Issued in GA
Practice address
632 Garland TRL
Harlem, GA 30814-5152
Phone
(706) 699-7139
NPI assigned
Apr 9, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN233862 GA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X NP233862 GA Primary

Addresses

Primary practice location

632 Garland TRL
Harlem, GA 30814-5152

Mailing address

632 Garland TRL
Harlem, GA 30814-5152
Phone (706) 699-7138

Other practice location 1

3643 Walton Way Ext Ste 7B
Augusta, GA 30909-4533
Phone (762) 218-5328

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
I20251226000649 GA Practitioner - Nurse Practitioner 4082100201 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Inpatient Consultants of Georgia, IncGroup PAC ID 2264539618, 13 clinicians

Practice addresses (Care Compare)

813 Atlanta Hwy
Warrenton, GA 30828-9105
Phone (706) 465-3328

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor of Arts

State licenses

LicenseStateTypeSpecialty
RN233862GAMDRegistered Nurse
NP233862GAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
CS Pacs 3 Southeast, LLC CurrentSince Apr 1, 2026 Accepting new patients
Your Story Medical Solution LLC Psychiatric/Mental Health CurrentSince Aug 25, 2025 Accepting new patients
Inpatient Consultants of Georgia, Inc CurrentSince Apr 1, 2026 Accepting new patients
Global Mentality Inc Psychiatric/Mental Health CurrentSince Nov 4, 2025 Accepting new patients
Global Mentality Psychiatric/Mental Health CurrentSince Nov 4, 2025 Accepting new patients

Locations

4246 Washington Rd
Ste 8
Evans, GA 30809
Phone (762) 218-5328

813 Atlanta Hwy
Warrenton, GA 30828
Phone (706) 465-3328

Organizations & group practices 5

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": "1744156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769644800000",
    "number": "1992599203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "632 GARLAND TRL",
            "city": "HARLEM",
            "state": "GA",
            "postal_code": "308145152",
            "telephone_number": "706-699-7138",
            "fax_number": "706-948-8780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "632 GARLAND TRL",
            "city": "HARLEM",
            "state": "GA",
            "postal_code": "308145152",
            "telephone_number": "706-699-7139"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3643 Walton Way Ext Ste 7B",
            "address_purpose": "LOCATION",
            "city": "Augusta",
            "state": "GA",
            "postal_code": "309094533",
            "country_code": "US",
            "telephone_number": "762-218-5328",
            "fax_number": "631-350-0321",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STORY",
        "first_name": "EBONY",
        "middle_name": "NICHOLE",
        "credential": "PMHNP, APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-09",
        "last_updated": "2026-01-29",
        "certification_date": "2026-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GA",
            "license": "RN233862",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "GA",
            "license": "NP233862",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Harlem, GA

Sources for this page

Verify at the official NPI Registry.