Individual provider Active NPI

Lori A Dalcour, NP

  • Women's Health Nurse Practitioner
  • Atlanta, GA
National Provider Identifier
1013241736
Registry record updated Sep 28, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
RN094340 Issued in GA
Practice address
340 Boulevard NE
Atlanta, GA 30312-1273
Phone
(404) 223-2229
NPI assigned
Sep 28, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 28, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X RN094340 GA Primary

Addresses

Primary practice location

340 Boulevard NE
Atlanta, GA 30312-1273

Mailing address

340 Boulevard NE
Atlanta, GA 30312-1273
Phone (404) 223-2229

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
I20120904000146 GA Practitioner - Nurse Practitioner 7618124231 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southside Medical Center, Inc. CurrentSince Jul 16, 2012 Accepting new patients
Southside Medical Center, Inc CurrentSince Jul 16, 2012 Accepting new patients

Locations

1046 Ridge Ave SW
Atlanta, GA 30315
Phone (404) 564-6942

1039 Ridge Ave SW
Atlanta, GA 30315
Phone (407) 761-8640

Interoperability endpoints

  • Direct secure messaging: lori.dalcour.1@11076.direct.athenahealth.com

Organizations & group practices 2

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": "1254096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1254096000000",
    "number": "1013241736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 BOULEVARD NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303121273",
            "telephone_number": "404-223-2229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 BOULEVARD NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303121273",
            "telephone_number": "404-223-2229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DALCOUR",
        "first_name": "LORI",
        "middle_name": "A",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-09-28",
        "last_updated": "2009-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "GA",
            "license": "RN094340",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.