Individual provider Active NPI

Susan E. Lomax, CPNP

  • Pediatric Nurse Practitioner
  • Marietta, GA
National Provider Identifier
1194873828
Registry record updated Aug 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
RN117846 Issued in GA
Practice address
777 Franklin Rd SE
Marietta, GA 30067-7803
Phone
(770) 732-6007
Fax
(770) 732-8242
NPI assigned
Jan 8, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 117846 GA
Pediatric Nurse Practitioner 363LP0200X RN117846 GA Primary

Addresses

Primary practice location

777 Franklin Rd SE
Marietta, GA 30067-7803

Mailing address

777 Franklin Rd SE
Marietta, GA 30067-7803
Phone (770) 732-6007

Other identifiers 4

IdentifierTypeStateIssuer
11194873828OtherGANPI
818552480AOtherGAMEDICAID PAYEE ID
818552480AMedicaidGA
000874057IMedicaidGA

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)
Not enrolled
Credentials
Certified Pediatric Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
117846GAMDPediatric Nurse Practitioner
RN117846GAMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Carrollton Pediatric Clinic, P.C. Past Accepting new patients
Nuestros Ninos Our Kids Pediatrics Inc. Pediatrics Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: susan.lomax1@gadirect.net

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": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343779200000",
    "number": "1194873828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 FRANKLIN RD SE",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300677803",
            "telephone_number": "770-732-6007",
            "fax_number": "770-732-8242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 FRANKLIN RD SE",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300677803",
            "telephone_number": "770-732-6007",
            "fax_number": "770-732-8242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOMAX",
        "first_name": "SUSAN",
        "middle_name": "E.",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-08",
        "last_updated": "2012-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "GA",
            "license": "117846",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "GA",
            "license": "RN117846",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "11194873828",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID PAYEE ID",
            "identifier": "818552480A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "818552480A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000874057I",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2012; 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.