Individual provider Active NPI

Lynley Suzanne Durrett, M.D.

  • Specialist
  • Atlanta, GA
National Provider Identifier
1073501169
Registry record updated Jun 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
044912 Issued in GA
Practice address
105 Collier Rd NW
Suite 1080
Atlanta, GA 30309-1710
Phone
(404) 352-2850
Fax
(404) 352-0947
NPI assigned
Oct 12, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 044912 GA Primary

Addresses

Primary practice location

105 Collier Rd NW
Suite 1080
Atlanta, GA 30309-1710

Mailing address

105 Collier Rd NW
Suite 1080
Atlanta, GA 30309-1710
Phone (404) 352-2850

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Apr 1, 2017 through Apr 1, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
044912GAMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1129075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277078400000",
    "number": "1073501169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 COLLIER RD NW",
            "address_2": "SUITE 1080",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303091710",
            "telephone_number": "404-352-2850",
            "fax_number": "404-352-0947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 COLLIER RD NW",
            "address_2": "SUITE 1080",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303091710",
            "telephone_number": "404-352-2850",
            "fax_number": "404-352-0947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DURRETT",
        "first_name": "LYNLEY",
        "middle_name": "SUZANNE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-12",
        "last_updated": "2010-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "GA",
            "license": "044912",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.