Individual provider Active NPI

Lyndsey Lea Oglesby, CPNP

  • Pediatric Nurse Practitioner
  • Atlanta, GA
National Provider Identifier
1093063273
Registry record updated Jan 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
RN180967 Issued in GA
Practice address
5455 Meridian Marks Rd NE
Atlanta, GA 30342-1654
Phone
(404) 785-2849
NPI assigned
Aug 20, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X RN180967 GA Primary

Addresses

Primary practice location

5455 Meridian Marks Rd NE
Atlanta, GA 30342-1654

Mailing address

1520 Carswell Rd
Wadley, GA 30477-4133
Phone (678) 773-0135

Other identifiers 1

IdentifierTypeStateIssuer
003127743FMedicaidGA

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
I20231011002100 GA Practitioner - Nurse Practitioner 5395190391 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN180967GAMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hospital Authority of Jefferson County and the City of Louisville CurrentSince Aug 1, 2023 Accepting new patients
Hospital Authority of Jefferson County and the City of Louisville CurrentSince Aug 1, 2023 Accepting new patients
Hospital Authority of Jefferson County and the City of Louisville Past Accepting new patients
Hospital Authority of Jefferson County and the City of Louisville Past Accepting new patients

Locations

1067 Peachtree St
#104
Louisville, GA 30434
Phone (912) 625-7000

1067 Peachtree St
Louisville, GA 30434
Phone (478) 625-7000

400 Canterbury Dr
Wrens, GA 30833
Phone (478) 625-7000

Organizations & group practices 4

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": "1345420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675123200000",
    "number": "1093063273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1520 CARSWELL RD",
            "city": "WADLEY",
            "state": "GA",
            "postal_code": "304774133",
            "telephone_number": "678-773-0135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5455 MERIDIAN MARKS RD NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421654",
            "telephone_number": "404-785-2849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OGLESBY",
        "first_name": "LYNDSEY",
        "middle_name": "LEA",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-20",
        "last_updated": "2023-01-31",
        "certification_date": "2023-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "GA",
            "license": "RN180967",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003127743F",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.