ANSON CHIN – Psychiatric/Mental Health Nurse Practitioner, NPI 1033911136

ANSON CHIN is a healthcare provider. based in Douglasville, Georgia. specializing in NURSE PRACTITIONER. They hold a License No. APRN-NP309560 (GA). The NPI Number for ANSON CHIN is 1033911136

Main info

Male
2 Years Of Experience
Name
ANSON CHIN
NPI
1033911136
Phone
(786) 916-1537
Address
96 WELLINGTON WALK
Enumeration Date
27 March 2025
Last Update Date
10 October 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7708123580
Graduation Year
2024 (2 years ago)
PAC ID
6608390380
Group Practice PAC ID
2163714635
Professional Enrollment ID
I20250403003790
Address ID
GA301803201VI101XXDRXX302
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness85
Years active:1State licenses:1Digital endpointsOther names

9,652 NURSE PRACTITIONER in GA

Provider Addresses for ANSON CHIN

  • 96 WELLINGTON WALK

    DOUGLASVILLE, GA 301346364

    Phone: (786) 916-1537

    Type: Mailing

  • 20 HERRELL RD

    VILLA RICA, GA 301805527

    Phone: (770) 812-3283

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-04-03

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250403003790INurse PractitionerGATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 30134)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2163714635View full group profile
NameSpecialtyState
P S Y C H I A T R YGA
P S Y C H I A T R YFL
P S Y C H I A T R YGA
P S Y C H I A T R YGA
Nurse PractitionerGA
-AL
Ophthalmology, PsychiatryGA
Nurse PractitionerGA
-FL
Nurse PractitionerGA

Reviews

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Frequently asked questions

Can I verify ANSON CHIN with an NPI only?
You can start verification with NPI 1033911136 for ANSON CHIN, then check state licensing separately.
Is ANSON CHIN still practicing?
ANSON CHIN is currently listed as active in the public NPI registry.
What is ANSON CHIN's specialty?
The listing groups ANSON CHIN with Psychiatric/Mental Health Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Where is ANSON CHIN based?
ANSON CHIN is tied to Douglasville, Georgia in the data we show; additional addresses may exist on the full record.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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