Active NPI
Resa A Lord, CPNP
- Pediatric Nurse Practitioner
- Columbus, GA
National Provider Identifier
1003080789
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- RN087816
- Practice address
- 705 17TH St
Suite 107
Columbus, GA 31901-3500 - Phone
- (706) 571-1665
- Fax
- (706) 660-2699
- NPI assigned
- Apr 15, 2008
- Last updated
- Apr 15, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | RN087816 | GA | Primary |
Addresses
Primary practice location
705 17TH St
Suite 107
Columbus, GA 31901-3500
Mailing address
705 17TH St
Suite 107
Columbus, GA 31901-3500
Phone (706) 571-1665
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| RN087816 | Other | GA | LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Certified Pediatric Nurse Practitioner, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN087816 | GA | MD | Pediatric Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1208217600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1208217600000",
"number": "1003080789",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "705 17TH ST",
"address_2": "SUITE 107",
"city": "COLUMBUS",
"state": "GA",
"postal_code": "319013500",
"telephone_number": "706-571-1665",
"fax_number": "706-660-2699"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "705 17TH ST",
"address_2": "SUITE 107",
"city": "COLUMBUS",
"state": "GA",
"postal_code": "319013500",
"telephone_number": "706-571-1665",
"fax_number": "706-660-2699"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LORD",
"first_name": "RESA",
"middle_name": "A",
"credential": "CPNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-04-15",
"last_updated": "2008-04-15",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "GA",
"license": "RN087816",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "RN087816",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Columbus, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.