Individual provider Active NPI

Lauren Michele Fisher, PA-C

  • Physician Assistant
  • Alpharetta, GA
National Provider Identifier
1093967648
Registry record updated Sep 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
006140 Issued in GA
Practice address
11800 Atlantis PL
Alpharetta, GA 30022-1160
Phone
(770) 360-8881
Fax
(770) 255-2533
NPI assigned
Oct 15, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2011

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 006140 GA Primary
Physician Assistant 363A00000X PA030559 DC
Physician Assistant 363A00000X C04191 MD

Addresses

Primary practice location

11800 Atlantis PL
Alpharetta, GA 30022-1160

Mailing address

11800 Atlantis PL
Alpharetta, GA 30022-1160
Phone (770) 360-8881

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
I20131226000821 GA Practitioner - Physician Assistant 0547329153 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
George Washington University School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aqua Dermatology of Georgia PCGroup PAC ID 6800885757, 56 clinicians

Practice addresses (Care Compare)

835 Cogburn Ave NW
Suite 100
Marietta, GA 30060-1008
Phone (770) 422-5557

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
C04191MDMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Dermatopathology Lab of Skin Cancer Specialists, P.C. CurrentSince Nov 1, 2021 Accepting new patients

Locations

10 Cloverleaf Dr
Cartersville, GA 30120
Phone (770) 386-1261

1150 Brookstone Centre Pkwy
Columbus, GA 31904
Phone (706) 257-4189

850 Charles Hardy Pkwy
Dallas, GA 30157
Phone (770) 336-8888

835 Cogburn Ave NW
Ste 100
Marietta, GA 30060
Phone (770) 422-5557

2045 Highway 34 E
Newnan, GA 30265
Phone (770) 502-0202

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": "1224028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315958400000",
    "number": "1093967648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11800 ATLANTIS PL",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300221160",
            "telephone_number": "770-360-8881",
            "fax_number": "770-255-2533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11800 ATLANTIS PL",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300221160",
            "telephone_number": "770-360-8881",
            "fax_number": "770-255-2533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISHER",
        "first_name": "LAUREN",
        "middle_name": "MICHELE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-15",
        "last_updated": "2011-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "006140",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "DC",
            "license": "PA030559",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C04191",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alpharetta, GA

Sources for this page

Verify at the official NPI Registry.