Individual provider Active NPI

Glynis Leflore, LPN

  • Licensed Practical Nurse
  • Mableton, GA
National Provider Identifier
1215637772
Registry record updated Mar 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
LPN094252 Issued in GA
Practice address
4745 Legacy Cove LN
Mableton, GA 30126-2580
Phone
(404) 769-2464
NPI assigned
Mar 3, 2023
Last updated
Mar 3, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2023

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

Specialties & licenses 12

Specialty (taxonomy)CodeLicenseStatePrimary
Pastoral Counselor 101YP1600X NU
Chore Provider 372500000X NU
Adult Companion 372600000X NU
Day Training/Habilitation Specialist 373H00000X NU
Attendant Care Provider 3747A0650X NU
Personal Care Attendant 3747P1801X NU
Religious Nonmedical Nursing Personnel 374T00000X NU
Nursing Home Administrator 376G00000X NU
Homemaker 376J00000X NU
Licensed Practical Nurse 164W00000X LPN094252 GA Primary
Case Manager/Care Coordinator 171M00000X NU
Religious Nonmedical Practitioner 374K00000X NU

Addresses

Primary practice location

4745 Legacy Cove LN
Mableton, GA 30126-2580

Mailing address

4480 S Cobb Dr SE Unit H477
Smyrna, GA 30080-6990
Phone (404) 769-2464

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

State licenses

LicenseStateTypeSpecialty
LPN094252GAMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Capitol Home Care Services of Georgia LLC Case Manager/Care Coordinator Current Accepting new patients
Phlebo on the Go LLC Current Accepting new patients
1 Capital Solutions PLLC Current Accepting new patients

Locations

633 Chestnut St
Ste 600
Chattanooga, TN 37450
Phone (404) 769-2464

Organizations & group practices 3

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": "1677801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677801600000",
    "number": "1215637772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4480 S COBB DR SE UNIT H477",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300806990",
            "telephone_number": "404-769-2464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4745 LEGACY COVE LN",
            "city": "MABLETON",
            "state": "GA",
            "postal_code": "301262580",
            "telephone_number": "404-769-2464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEFLORE",
        "first_name": "GLYNIS",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-03",
        "last_updated": "2023-03-03",
        "certification_date": "2023-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP1600X",
            "taxonomy_group": "",
            "desc": "Counselor, Pastoral",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "372500000X",
            "taxonomy_group": "",
            "desc": "Chore Provider",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "372600000X",
            "taxonomy_group": "",
            "desc": "Adult Companion",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "373H00000X",
            "taxonomy_group": "",
            "desc": "Day Training/Habilitation Specialist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3747A0650X",
            "taxonomy_group": "",
            "desc": "Technician, Attendant Care Provider",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "374T00000X",
            "taxonomy_group": "",
            "desc": "Religious Nonmedical Nursing Personnel",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "376G00000X",
            "taxonomy_group": "",
            "desc": "Nursing Home Administrator",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "376J00000X",
            "taxonomy_group": "",
            "desc": "Homemaker",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "GA",
            "license": "LPN094252",
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "374K00000X",
            "taxonomy_group": "",
            "desc": "Religious Nonmedical Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mableton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2023; 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.