Individual provider Active NPI

Lisa Paige McBryar, NP

  • Nurse Practitioner
  • Atlanta, GA
National Provider Identifier
1205954021
Registry record updated Mar 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN112936 Issued in GA
Practice address
970 Sidney Marcus Blvd
2201
Atlanta, GA 30324
Phone
(770) 331-0425
Fax
(678) 347-2104
NPI assigned
Mar 27, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN112936 GA Primary

Addresses

Primary practice location

970 Sidney Marcus Blvd
2201
Atlanta, GA 30324

Mailing address

970 Sidney Marcus Blvd NE
#2201
Atlanta, GA 30324-5613
Phone (770) 331-0425

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
I20130904000877 GA Practitioner - Nurse Practitioner 2062655475 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Georgia Mountains Community Services CurrentSince May 23, 2018 Accepting new patients

Locations

150A Johnson St
Dahlonega, GA 30533
Phone (706) 864-6822

Interoperability endpoints

  • Direct secure messaging: lisa.mcbryar.1@25899.direct.athenahealth.com

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": "1174953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1267401600000",
    "number": "1205954021",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "970 SIDNEY MARCUS BLVD NE",
            "address_2": "#2201",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303245613",
            "telephone_number": "770-331-0425",
            "fax_number": "678-347-2104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "970 SIDNEY MARCUS BLVD",
            "address_2": "2201",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30324",
            "telephone_number": "770-331-0425",
            "fax_number": "678-347-2104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCBRYAR",
        "first_name": "LISA",
        "middle_name": "PAIGE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-27",
        "last_updated": "2010-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN112936",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.