KELLY PRINCE MIXON NP
NPI 1376121426
Nurse Practitioner - Family in Thomasville, GA
About Kelly Prince Mixon Np NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KELLY PRINCE MIXON NP (NPI 1376121426) is an individual family provider in Thomasville, Georgia, licensed in Georgia (RN254729) and active in the NPI registry since March 2021. She is enrolled in Medicare PECOS, is affiliated with Archbold Memorial, and is a graduate of Other (2020).
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Kelly Prince Mixon Np is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignments
2Medicare enrollment records show Kelly Mixon reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Thomasville, GA 31792
- Reassigned Medicare billing, Georgia enrollment
- 25 clinicians in this Medicare group
Thomasville, GA 31792
- Reassigned Medicare billing, Georgia enrollment
- 99 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Areas of Expertise CMS Part B claims 2
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
Hospital Affiliations CMS Care Compare 2
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Archbold Memorial
Acute Care Hospitals · Thomasville, GAArchbold Grady
Acute Care Hospitals · Cairo, GAPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 31792 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
THOMASVILLE, GA 31792
THOMASVILLE, GA 31792
THOMASVILLE, GA 31792
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Kelly Mixon's NPI number?
The NPI number for Kelly Mixon is 1376121426. It was assigned to this individual provider in the NPPES registry on March 31, 2021.
Where is Kelly Mixon located?
Kelly Mixon practices at 116 Mimosa Dr, Thomasville, GA 31792. The listed phone number is (229) 584-5570.
What is Kelly Mixon's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Kelly Mixon enrolled in Medicare?
Yes. Kelly Mixon is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organizations bill Medicare for Kelly Mixon's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Kelly Mixon reassigns Medicare benefits to 2 organizations: Ccsg, Inc. (Thomasville, GA) and John D Archbold Memorial Hospital Inc (Thomasville, GA). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kelly Mixon's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Kelly Mixon accept?
Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama, Ambetter of North Carolina and Ambetter of Tennessee list Kelly Mixon as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
Is Kelly Mixon affiliated with any hospitals?
According to CMS data, Kelly Mixon is affiliated with Archbold Memorial and Archbold Grady.
When was this NPI record last updated?
The NPPES record for Kelly Mixon was last updated on September 29, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Kelly Prince Mixon, NP · NPI 1376121426
Family physician in Thomasville, Georgia. Individual provider, active in the CMS NPPES registry since March 31, 2021.
## Identity
- **NPI:** 1376121426 (Entity type: Individual)
- **Enumerated:** March 31, 2021
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** RN254729 (Georgia)
- **Sole proprietor:** No
## Practice location
- **Address:** 116 MIMOSA DR, Thomasville, GA 31792-6605
- **Phone:** (229) 584-5570 · **Fax:** (229) 551-8697
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Ccsg, Inc. (NPI 1295120145, Thomasville, GA); John D Archbold Memorial Hospital Inc (NPI 1194779702, Thomasville, GA) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2020
## Record status
- **NPPES last updated:** September 29, 2026
- **Other identifiers:** Other 056052474 (GA)
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Source: [NPI Profile](https://npiprofile.com/npi/1376121426) · Data from the CMS NPPES public registry.