Active NPI
Lisa A Reed, PNP-C
- Pediatric Nurse Practitioner
- Calhoun, GA
National Provider Identifier
1225049109
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- RN149133 NP
- Practice address
- 204 Professional CT SE
Ste. 400
Calhoun, GA 30701-7020 - Phone
- (706) 625-5900
- Fax
- (678) 721-4675
- NPI assigned
- Aug 10, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | RN149133 NP | GA | Primary |
Addresses
Primary practice location
204 Professional CT SE
Ste. 400
Calhoun, GA 30701-7020
Mailing address
204 Professional CT SE
Calhoun, GA 30701-7020
Phone (770) 546-5578
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 203000015B | Medicaid | GA | |
| 20030098 | Other | GA | PEDIATRIC CERTIFICATION |
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
| License | State | Type | Specialty |
|---|---|---|---|
| RN149133 NP | GA | MD | Pediatric Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Agc Pediatrics, LLC | Past | Accepting new patients | |
| Agc Pediatrics, LLC | Pediatrics | Past | Accepting new patients |
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/DEJAAA
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Specialist
- Calhoun, GA
- NPI 1356475214
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155168000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1470268800000",
"number": "1225049109",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "204 PROFESSIONAL CT SE",
"city": "CALHOUN",
"state": "GA",
"postal_code": "307017020",
"telephone_number": "770-546-5578",
"fax_number": "806-771-0305"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "204 PROFESSIONAL CT SE",
"address_2": "STE. 400",
"city": "CALHOUN",
"state": "GA",
"postal_code": "307017020",
"telephone_number": "706-625-5900",
"fax_number": "678-721-4675"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REED",
"first_name": "LISA",
"middle_name": "A",
"credential": "PNP-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-10",
"last_updated": "2016-08-04",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "GA",
"license": "RN149133 NP",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "203000015B",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PEDIATRIC CERTIFICATION",
"identifier": "20030098",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Calhoun, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.