Individual provider Active NPI

Dawn Aiesha Printup, FNP-BC

  • Family Nurse Practitioner
  • Fayetteville, GA
National Provider Identifier
1124895768
Registry record updated May 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN-NP233945 Issued in GA
Practice address
1279 Highway 54 W Ste 100
Fayetteville, GA 30214-4551
Phone
(770) 719-5710
NPI assigned
Dec 5, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN-NP233945 GA Primary

Addresses

Primary practice location

1279 Highway 54 W Ste 100
Fayetteville, GA 30214-4551

Mailing address

1948 Old Ocilla Rd
Tifton, GA 31794-1644
Phone (229) 391-3500

Other practice location 1

1130 Hurricane Shoals Rd NE Ste 2250
Lawrenceville, GA 30043-4890
Phone (229) 391-3500

Other practice location 2

484 Irvin Ct
Decatur, GA 30030-5406
Phone (229) 391-3500

Other practice location 3

10600 Lochridge Blvd
Covington, GA 30014-4411
Phone (229) 391-3500

Other practice location 4

1060 Gaines School Rd
Athens, GA 30605-3198
Phone (229) 391-3500

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
I20260417003430 GA Practitioner - Nurse Practitioner 0345716171 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Piedmont Providers LLCGroup PAC ID 9830082825, 526 clinicians

Practice addresses (Care Compare)

1984 Peachtree Rd NW
Suite 300
Atlanta, GA 30309-5219
Phone (404) 367-3210

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APRN-NP233945GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Piedmont Providers LLC PastSince Feb 26, 2018 Accepting new patients
Womens Center for Advanced Surgery Inc Past Accepting new patients
United Obstetrics and Gynecology, P.C. Past Accepting new patients

Organizations & group practices 3

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": "1701734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778803200000",
    "number": "1124895768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1948 OLD OCILLA RD",
            "city": "TIFTON",
            "state": "GA",
            "postal_code": "317941644",
            "telephone_number": "229-391-3500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1279 HIGHWAY 54 W STE 100",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302144551",
            "telephone_number": "770-719-5710"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1130 Hurricane Shoals Rd NE Ste 2250",
            "address_purpose": "LOCATION",
            "city": "Lawrenceville",
            "state": "GA",
            "postal_code": "300434890",
            "country_code": "US",
            "telephone_number": "229-391-3500",
            "fax_number": "770-910-7088",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "484 Irvin Ct",
            "address_purpose": "LOCATION",
            "city": "Decatur",
            "state": "GA",
            "postal_code": "300305406",
            "country_code": "US",
            "telephone_number": "229-391-3500",
            "fax_number": "678-823-9750",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10600 Lochridge Blvd",
            "address_purpose": "LOCATION",
            "city": "Covington",
            "state": "GA",
            "postal_code": "300144411",
            "country_code": "US",
            "telephone_number": "229-391-3500",
            "fax_number": "229-386-1016",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1060 Gaines School Rd",
            "address_purpose": "LOCATION",
            "city": "Athens",
            "state": "GA",
            "postal_code": "306053198",
            "country_code": "US",
            "telephone_number": "229-391-3500",
            "fax_number": "706-850-5352",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PRINTUP",
        "first_name": "DAWN",
        "middle_name": "AIESHA",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-05",
        "last_updated": "2026-05-15",
        "certification_date": "2026-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "APRN-NP233945",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, GA

Sources for this page

Verify at the official NPI Registry.