Lisa Ann Swofford, FNP
Individual provider Active NPI Nurse Practitioner · Colquitt, GA
NPI 1083667448 · NPPES record last updated Oct 13, 2025
Key facts
- NPI
- 1083667448
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- RN132537NP (GA)
- Practice address
- 103 W Pine St
Colquitt, GA 39837-3526 - Phone
- (229) 758-3002
- Fax
- (229) 758-9415
- NPI assigned
- May 18, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2005
- Medicare assignment
- May accept Medicare assignment
- Group practices
- Colquitt Complete Care LLC
Practice addresses (Care Compare)
103 W Pine St
Colquitt, GA 39837-3526
Phone (229) 758-3002
Hospital & facility affiliations
- Miller County Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20060103000450 | GA | Practitioner - Nurse Practitioner | 9931121043 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN132537NP | GA | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Colquitt Complete Care LLC | Current |
Accepting new patients | |
| Hospital Authority of the City of Bainbridge and Decatur County | Past | Accepting new patients |
Locations
103 W Pine St
Colquitt, GA 39837
Phone (229) 758-3002
112 N Cuthbert St
Colquitt, GA 39837
210 W Main St
Ste 4
Colquitt, GA 39837
Phone (229) 758-3002
209 N Cuthbert St
Colquitt, GA 39837
Phone (229) 758-3385
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | RN132537NP | GA | Yes |
Addresses
Primary practice location
103 W Pine St
Colquitt, GA 39837-3526
Mailing address
112 N Cuthbert St
Colquitt, GA 39837-3419
Phone (229) 758-3002
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 913150787A | Medicaid | GA |
Other names
- Lisa A Peterson
Other providers in Colquitt, GA
- Roy Richard Reardon
- Rxdirect
- Amy Askew Sanderson
- Rebecca Ellen Saunders
- Tamara G Spann
- William Swofford
- Mary Elizabeth Sykes
- Jessica Temples
- The Hospital Authority of Miller County
- The Hospital Authority of Miller County
All providers in Colquitt, GA · Nurse Practitioner in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 13, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.