Individual provider Active NPI

Victoria Lord Carr, PA

  • Surgical Physician Assistant
  • Smyrna, GA
National Provider Identifier
1114345089
Registry record updated May 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
008635 Issued in GA
Practice address
3903 S Cobb Dr SE
Smyrna, GA 30080-8504
Phone
(404) 251-2112
NPI assigned
Mar 28, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA08985 TX
Surgical Physician Assistant 363AS0400X 008635 GA Primary

Addresses

Primary practice location

3903 S Cobb Dr SE
Smyrna, GA 30080-8504

Mailing address

3540 Lee St SE
Smyrna, GA 30080-5622

Other names 1

  • Victoria Elizabeth Lord Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
008635GAMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Capital Orthopaedic Clinic, PLLC PastSince Oct 20, 2019 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: vcarr35291@direct.emory.org

Organizations & group practices 1

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": "1395964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651449600000",
    "number": "1114345089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3540 LEE ST SE",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300805622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3903 S COBB DR SE",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300808504",
            "telephone_number": "404-251-2112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARR",
        "first_name": "VICTORIA",
        "middle_name": "LORD",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-28",
        "last_updated": "2022-05-02",
        "certification_date": "2022-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "TX",
            "license": "PA08985",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "GA",
            "license": "008635",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VICTORIA",
            "last_name": "LORD",
            "middle_name": "ELIZABETH",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Smyrna, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.