MRS. CARISALYN NICOLE COUSIN (APRN BC) – Family Nurse Practitioner, NPI 1124085972
Family Nurse Practitioner
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Doctor Profile
Contacts
Profile Insights
NPPES metrics only — not quality of care.
9,652 NURSE PRACTITIONER in GA
Provider Addresses for MRS. CARISALYN NICOLE COUSIN (APRN BC)
Packard Street, Ann Arbor, Washtenaw County, Michigan, 48108, United States
ANN ARBOR, MI 481081947
Phone: (734) 971-1073
Type: Mailing
PO BOX 12938
C/O CLINIC MANAGEMENT
CALHOUN, GA 30703
Phone: (706) 602-7800
Type: Mailing
12 MEDICAL DR NE
CARTERSVILLE, GA 301218002
Phone: (770) 386-1000
Fax: (770) 386-9165
Type: Location
PO BOX 200185
CARTERSVILLE, GA 301209027
Phone: (770) 386-1000
Fax: (770) 386-9165
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 140 Open Payments records for all available years, with a total value of $2,422.
Total Amount is formed as General ($2,422) + Research ($0) + Ownership ($0) = $2,422.
Last reported payment date: 2024-12-16 • Largest payer in this snapshot: Lilly USA, LLC ($317).
Total Amount
$2,422
General + Research + Ownership
Payments
140
Total payment records
General Amount
$2,422
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-16
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Lilly USA, LLC | $317 |
| Novo Nordisk Inc | $314 |
| ABBVIE INC. | $310 |
| PFIZER INC. | $135 |
| Abbott Laboratories | $89 |
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: 2021-10-28
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20211028000339 | I | Nurse Practitioner | GA | TBD |
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.
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 48108)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Family Practice | GA | |
| N E U R O S U R G E R Y | GA | |
| Urology, Surgical Oncology | GA | |
| Internal Medicine | GA | |
| General Surgery | GA | |
| N E U R O S U R G E R Y | VA | |
| Nurse Practitioner | GA | |
| Physician Assistant | GA | |
| Nurse Practitioner | GA | |
| Nurse Practitioner | GA |
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