Individual provider Active NPI

Maquissa Lashanta Thomas, MS,WHNP

  • Nurse Practitioner
  • Carrollton, GA
National Provider Identifier
1154753978
Registry record updated Oct 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN154661 Issued in GA
Practice address
200 Glen Eagle CT Ste 5a
Carrollton, GA 30117-4267
Phone
(770) 377-2456
NPI assigned
Aug 2, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X RN154661 GA
Nurse Practitioner 363L00000X RN154661 GA Primary

Addresses

Primary practice location

200 Glen Eagle CT Ste 5a
Carrollton, GA 30117-4267

Mailing address

200 Glen Eagle CT Ste 4a
Carrollton, GA 30117-4267
Phone (770) 377-2456

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
Master of Science

State licenses

LicenseStateTypeSpecialty
RN154661GAMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Amnestic, LLC PastSince Nov 8, 2017 Accepting new patients

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": "1375401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760313600000",
    "number": "1154753978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 GLEN EAGLE CT STE 4A",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301174267",
            "telephone_number": "770-377-2456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 GLEN EAGLE CT STE 5A",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301174267",
            "telephone_number": "770-377-2456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "MAQUISSA",
        "middle_name": "LASHANTA",
        "name_prefix": "Mrs.",
        "credential": "MS,WHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-02",
        "last_updated": "2025-10-13",
        "certification_date": "2025-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "GA",
            "license": "RN154661",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN154661",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carrollton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2025; 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.