Marie Lightbourne, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

001826 Issued in GA

Practice address

2356 Lenora Church Rd
Snellville, GA 30078-3233

Phone

(770) 972-0340

Fax

(770) 972-0379

NPI assigned

Jan 25, 2008

Last updated

Jun 3, 2011By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Other, 2006

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Phoenix Clinic and Afterhour Care

  • Family Medicine Physician
  • Snellville, GA
  • NPI 1720569403
  Medicare reassignment NPD Authorized official
• Emory Specialty Associates, LLC

  • Anesthesiology Physician
  • Lagrange, GA
  • NPI 1407864168

  Family Medicine

  NPD (past)

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

{
    "created_epoch": "1201219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307059200000",
    "number": "1114104767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2356 LENORA CHURCH ROAD",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "30078",
            "telephone_number": "770-972-0340",
            "fax_number": "770-972-0379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2356 LENORA CHURCH RD",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300783233",
            "telephone_number": "770-972-0340",
            "fax_number": "770-972-0379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIGHTBOURNE",
        "first_name": "MARIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-25",
        "last_updated": "2011-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "001826",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kasey Lila Lieu, FNP-C
• Life Clarity Group
• Life Healing Center PC
• Life Medical Supply, LLC
• Lifestyle Pain Management and Wellness Center, PC
• Lillies Totalcare
• Janice C Lim, MD
• Linda L Casteel, MD, PC
• Litchfield Homes LLC (Elitr CLA)
• Little Angels Home Care

• Family Medicine Physician in Snellville, GA
• Providers in Snellville, GA by specialty
• Family Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.