Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kelly Prince Mixon, NP

Individual provider Family Nurse Practitioner · NPI 1376121426

Kelly Prince Mixon, NP is a Nurse Practitioner in Thomasville, Georgia. Qualified in 2020, 6 years ago. Practices with Ccsg, Inc, a 26-clinician group and accepts Medicare assignment. Licensed in Georgia.

Years since qualifying
6
Licensed in
GA
In the registry since
2021
What do these letters mean?
NP — Nurse Practitioner
An advanced practice nurse who can diagnose, treat and in most states prescribe.

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Practice location Address checks out

116 Mimosa Dr
Thomasville, GA 31792-6605
Phone: (229) 584-5570
Fax: (229) 551-8697
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence RN254729 (GA)

Record details

NPI number1376121426
Entity typeIndividual (Type 1)
GenderFemale
Credentials NP
Sole proprietorNo
NPI enumeratedMarch 31, 2021
Last updated in NPPESNovember 13, 2023
Certification dateNovember 13, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Ccsg, Inc — 26 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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