Individual provider Active NPI

Lesia Herron

  • Primary Care Nurse Practitioner
  • Atlanta, GA
National Provider Identifier
1184054900
Registry record updated Dec 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
RN115103 Issued in GA
Practice address
3408 Noble Creek NWDR
Atlanta, GA 30327-5121
Phone
(804) 651-0000
Fax
(410) 569-7137
NPI assigned
Nov 14, 2013
Last updated
Dec 30, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X RN115103 GA Primary
Registered Nurse 163W00000X RN1020457 DC

Addresses

Primary practice location

3408 Noble Creek NWDR
Atlanta, GA 30327-5121

Mailing address

2020 Howell Mill Rd NW, D-421
Atlanta, GA 30318-1732
Phone (804) 651-0000

Other names 1

  • Lesia Herron Professional name

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
I20150424000909 GA Practitioner - Nurse Practitioner 6800115825 Reassigns benefits to 5 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN1020457DCMDRegistered Nurse
RN115103GAMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Small Hospital Innovations LLC CurrentSince Feb 15, 2023 Accepting new patients
Gwinnett Emergency Specialists, LLC CurrentSince Apr 1, 2016 Accepting new patients
The Family Health Centers of Georgia, Inc Current Accepting new patients
Gwinnett Emergency Specialists Observation Services, LLC CurrentSince Apr 1, 2016 Accepting new patients
The Family Health Centers of Georgia, Inc CurrentSince Jan 1, 2016 Accepting new patients
Georgia Emergency Group, LLC CurrentSince Feb 25, 2015 Accepting new patients
The Family Health Centers of Georgia, Inc CurrentSince Jan 1, 2016 Accepting new patients

Locations

868 York Ave SW
Atlanta, GA 30310

601 S 8th St
Griffin, GA 30224
Phone (770) 228-2721

1000 Medical Center Blvd
Lawrenceville, GA 30046
Phone (678) 312-3356

11 Upper Riverdale Rd SW
Riverdale, GA 30274
Phone (770) 897-7277

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

Organizations & group practices 8

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": "1384387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451433600000",
    "number": "1184054900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 HOWELL MILL RD NW, D-421",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303181732",
            "telephone_number": "804-651-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3408 NOBLE CREEK NWDR",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303275121",
            "telephone_number": "804-651-0000",
            "fax_number": "410-569-7137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERRON",
        "first_name": "LESIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-14",
        "last_updated": "2015-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "GA",
            "license": "RN115103",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "DC",
            "license": "RN1020457",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LESIA",
            "last_name": "HERRON",
            "credential": "RN",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.