Individual provider Active NPI

Lynn S. Vanliew, APRN,BC

  • Adult Psychiatric/Mental Health Clinical Nurse Specialist
  • Decatur, GA
National Provider Identifier
1003945098
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0809X
License
RN087348 Issued in GA
Practice address
450 Winn Way
Decatur, GA 30030-1715
Phone
(404) 294-0449
Fax
(404) 294-0793
NPI assigned
Mar 5, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Psychiatric/Mental Health Clinical Nurse Specialist 364SP0809X RN087348 GA Primary

Addresses

Primary practice location

450 Winn Way
Decatur, GA 30030-1715

Mailing address

2289 Brengare Dr
Decatur, GA 30033-4711
Phone (404) 329-8573

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050512000601 GA Practitioner - Certified Clinical Nurse Specialist (CNS) 9931140647 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Clinical Nurse Specialist (CNS)
Education
Other, 1983
Medicare assignment
May accept Medicare assignment
Group practices
Positive Impact Health Centers IncGroup PAC ID 5496721987, 25 clinicians

Practice addresses (Care Compare)

523 Church St
Decatur, GA 30030-2515
Phone (404) 589-9040

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Specialist

State licenses

LicenseStateTypeSpecialty
RNGAMDHospice Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Grady Memorial Hospital Corporation CurrentSince May 1, 2010 Accepting new patients
Positive Impact Health Centers, Inc. CurrentSince Apr 19, 2021 Accepting new patients
Positive Impact Health Centers Inc CurrentSince Apr 19, 2021 Accepting new patients
Grady Memorial Hospital Corporation CurrentSince May 1, 2010 Accepting new patients
Grady Memorial Hospital Corporation Past Accepting new patients

Locations

80 Jesse Hill Jr Dr SE
Atlanta, GA 30303
Phone (404) 616-4370

523 Church St
Decatur, GA 30030
Phone (404) 589-9040

3350 Breckinridge Blvd
Ste 200
Duluth, GA 30096
Phone (770) 962-8396

3075 Breckinridge Blvd
Ste 415
Duluth, GA 30096
Phone (770) 962-8396

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/6123adb2-d0d2-485a-9dcf-5fba87efb2ef/

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1003945098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2289 BRENGARE DR",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300334711",
            "telephone_number": "404-329-8573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 WINN WAY",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300301715",
            "telephone_number": "404-294-0449",
            "fax_number": "404-294-0793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANLIEW",
        "first_name": "LYNN",
        "middle_name": "S.",
        "name_prefix": "Mrs.",
        "credential": "APRN,BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SP0809X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Adult",
            "state": "GA",
            "license": "RN087348",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, GA

Sources for this page

Verify at the official NPI Registry.