Individual provider Active NPI

Patricia Natalie Dillon

  • Family Nurse Practitioner
  • Fayetteville, GA
National Provider Identifier
1114685773
Registry record updated Dec 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F02210017 Issued in GA
Practice address
315 Carriage Chase
Fayetteville, GA 30214-6905
Phone
(770) 882-4945
NPI assigned
Dec 1, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X F02210017 GA Primary

Addresses

Primary practice location

315 Carriage Chase
Fayetteville, GA 30214-6905

Mailing address

315 Carriage Chase
Fayetteville, GA 30214-6905
Phone (770) 882-4945

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL computer

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
I20230929002702 GA Practitioner - Nurse Practitioner 3173977725 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Peachtree Immediate Care FP, LLCGroup PAC ID 3274559323, 328 clinicians

Practice addresses (Care Compare)

1275 Hwy 54 W
Suite 201
Fayetteville, GA 30214-4538
Phone (770) 461-3776

Merit-based Incentive Payment System (MIPS)

Final score
94.51 of 100Reported as apm
Quality
80.61
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
F02210017GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Peachtree Immediate Care FP, LLC Single Specialty CurrentSince Oct 14, 2024 Accepting new patients
Restored Health Inc. Single Specialty CurrentSince Aug 23, 2023 Accepting new patients

Locations

1275 Highway 54 W
Ste 201
Fayetteville, GA 30214
Phone (770) 461-3776

590 Lanier Ave W
Fayetteville, GA 30214

3827 Jimmy Lee Smith Pkwy
Hiram, GA 30141
Phone (770) 222-8900

483 Indian Trl Lilburn Rd NW
#R
Lilburn, GA 30047
Phone (770) 923-4433

483 Indian Trl Lilburn Rd NW
Lilburn, GA 30047
Phone (770) 279-2427

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": "1638316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638316800000",
    "number": "1114685773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 CARRIAGE CHASE",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302146905",
            "telephone_number": "770-882-4945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 CARRIAGE CHASE",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302146905",
            "telephone_number": "770-882-4945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DILLON",
        "first_name": "PATRICIA",
        "middle_name": "NATALIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-12-01",
        "last_updated": "2021-12-01",
        "certification_date": "2021-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "F02210017",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "computer",
            "affiliation": "N",
            "address_1": "315 Carriage Chase",
            "city": "Fayetteville",
            "state": "GA",
            "country_code": "US",
            "postal_code": "302146905",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fayetteville, GA

Sources for this page

Verify at the official NPI Registry.