Individual provider Active NPI

Angela Kaye Llewellyn, NP, FNP-C

  • Family Nurse Practitioner
  • Dalton, GA
National Provider Identifier
1154801454
Registry record updated Aug 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
GAA-NP004402 Issued in GA
Practice address
1109 Burleyson Rd Ste 104
Dalton, GA 30720-3094
Phone
(706) 281-8490
Fax
(706) 529-8487
NPI assigned
Aug 16, 2018
Last updated
Aug 21, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2026

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X GAA-NP004402 GA Primary
Family Nurse Practitioner 363LF0000X 24474 TN
Family Medicine Physician 207Q00000X APN24474 TN
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 24474 TN
Psychiatric/Mental Health Nurse Practitioner 363LP0808X GAA-NP004402 GA

Addresses

Primary practice location

1109 Burleyson Rd Ste 104
Dalton, GA 30720-3094

Mailing address

1109 Burleyson Rd Ste 104
Dalton, GA 30720-3094
Phone (706) 281-8490

Other practice location 1

1875 Fant Dr
Ft Oglethorpe, GA 30742-3307
Phone (706) 861-3387

Other practice location 2

465 Winn Way Ste 130
Decatur, GA 30030-1722
Phone (832) 869-4818

Other practice location 3

325 Cherokee Blvd Ste 102
Chattanooga, TN 37405-4476
Phone (832) 869-4818

Other names 1

  • Mrs. Angela Kaye Richardson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, GA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20181126000004 TN Practitioner - Nurse Practitioner 6608120001 Reassigns benefits to 4 organizations
I20200124000834 GA Practitioner - Nurse Practitioner 6608120001 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Gateway Community Service BoardGroup PAC ID 3173510237, 42 clinicians

Practice addresses (Care Compare)

600 Coastal Village Dr
Brunswick, GA 31520-1973
Phone (912) 554-8000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APN24474TNMDForensic Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gateway Behavioral Health Services CurrentSince Sep 1, 2025 Accepting new patients
Hamilton Physician Group Inc CurrentSince Feb 26, 2024 Accepting new patients
Erlanger Behavioral Health, LLC CurrentSince Sep 18, 2018 Accepting new patients
State of Tennessee State F & a Payroll CurrentSince Mar 1, 2020 Accepting new patients
State of Tennessee CurrentSince Mar 1, 2020 Accepting new patients
Lookout Mountain Community Services CurrentSince Dec 1, 2019 Accepting new patients
State of Tennessee Current Accepting new patients
Gateway Community Service Board CurrentSince Sep 1, 2025 Accepting new patients
Lookout Mountain Community Services CurrentSince Dec 1, 2019 Accepting new patients
Lookout Mountain Community Services Current Accepting new patients

Locations

600 Coastal Village Dr
Brunswick, GA 31520
Phone (912) 449-7111

700 Coastal Village Dr
Brunswick, GA 31520
Phone (912) 554-8400

1109 Burleyson Rd
Ste 104
Dalton, GA 30720
Phone (706) 278-5961

1200 Memorial Dr
Dalton, GA 30720
Phone (706) 272-6115

1436 Broadrick Dr
Ste B
Dalton, GA 30720
Phone (706) 226-3434

110 Hedekin Cir
Ft Oglethorpe, GA 30742
Phone (706) 866-5945

1875 Fant Dr
Ft Oglethorpe, GA 30742
Phone (706) 861-3387

1113 E Oglethorpe Hwy
Hinesville, GA 31313
Phone (912) 280-7023

124 SW Broad St
Jesup, GA 31545
Phone (912) 280-7023

501 Mize St
La Fayette, GA 30728
Phone (706) 638-5591

100 Moccasin Bend Rd
Chattanooga, TN 37405
Phone (423) 785-3321

804 N Holtzclaw Ave
Chattanooga, TN 37404
Phone (423) 463-4408

Organizations & group practices 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1534377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787270400000",
    "number": "1154801454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1109 BURLEYSON RD STE 104",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307203094",
            "telephone_number": "706-281-8490",
            "fax_number": "706-529-8487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1109 BURLEYSON RD STE 104",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307203094",
            "telephone_number": "706-281-8490",
            "fax_number": "706-529-8487"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1875 Fant Dr",
            "address_purpose": "LOCATION",
            "city": "Ft Oglethorpe",
            "state": "GA",
            "postal_code": "307423307",
            "country_code": "US",
            "telephone_number": "706-861-3387",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "465 Winn Way Ste 130",
            "address_purpose": "LOCATION",
            "city": "Decatur",
            "state": "GA",
            "postal_code": "300301722",
            "country_code": "US",
            "telephone_number": "832-869-4818",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "325 Cherokee Blvd Ste 102",
            "address_purpose": "LOCATION",
            "city": "Chattanooga",
            "state": "TN",
            "postal_code": "374054476",
            "country_code": "US",
            "telephone_number": "832-869-4818",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LLEWELLYN",
        "first_name": "ANGELA",
        "middle_name": "KAYE",
        "name_prefix": "Mrs.",
        "credential": "NP, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-16",
        "last_updated": "2026-08-21",
        "certification_date": "2026-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "GAA-NP004402",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "24474",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "APN24474",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TN",
            "license": "24474",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "GA",
            "license": "GAA-NP004402",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANGELA",
            "last_name": "RICHARDSON",
            "middle_name": "KAYE",
            "prefix": "MRS.",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Dalton, GA

Sources for this page

Verify at the official NPI Registry.