Provenance Psychiatric Services LLC
NPI 1932885530 · Psychiatric/Mental Health Clinical Nurse Specialist · Blairsville, GA
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Provenance Psychiatric Services LLC is a Psychiatric/Mental Health Clinical Nurse Specialist organization in Blairsville, GA (NPI 1932885530).
Provider details
- NPI number
- 1932885530
- Entity type
- Organization
- Primary specialty
- Psychiatric/Mental Health Clinical Nurse SpecialistPhysician Assistants & Advanced Practice Nursing Providers
- Organization subpart
- No
- Authorized official
- Brian Johnson, Owner(610) 453-1548
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
2 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Other names (DBA / former)
- Doing business as
- Provenance Psychiatry
Registry dates
- Enumerated
- 2023-06-27
- Last updated
- 2025-03-19
- Certified
- 2025-03-19
Frequently asked questions
- What is Provenance Psychiatric Services LLC's NPI number?
- Provenance Psychiatric Services LLC's National Provider Identifier (NPI) is 1932885530, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Provenance Psychiatric Services LLC?
- Provenance Psychiatric Services LLC is classified in the NPPES registry as Psychiatric/Mental Health Clinical Nurse Specialist (Physician Assistants & Advanced Practice Nursing Providers).
- Where is Provenance Psychiatric Services LLC located?
- Provenance Psychiatric Services LLC's practice location on file with NPPES is 643 Ray Lewis Rd, Blairsville, GA 30512-1439.
- What is Provenance Psychiatric Services LLC's phone number?
- The practice phone number listed in the NPPES registry for Provenance Psychiatric Services LLC is (706) 970-1948.
- Does Provenance Psychiatric Services LLC accept Medicare?
- Provenance Psychiatric Services LLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Provenance Psychiatric Services LLC?
- The authorized official listed on Provenance Psychiatric Services LLC's NPPES record is Brian Johnson, Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Provenance Psychiatric Services LLC's NPI active?
- Yes — Provenance Psychiatric Services LLC's NPI (1932885530) is active in the NPPES registry as of the last update on 2025-03-19.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.