Individual provider Active NPI

Lauren Sisemore, LPN

  • Licensed Practical Nurse
  • Ringgold, GA
National Provider Identifier
1245788017
Registry record updated Sep 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
LPN083786 Issued in GA
Practice address
4083 Cloud Springs Rd
Ringgold, GA 30736-8411
Phone
(706) 820-6087
NPI assigned
Sep 21, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X LPN083786 GA Primary

Addresses

Primary practice location

4083 Cloud Springs Rd
Ringgold, GA 30736-8411

Mailing address

538 Spring Meadows Dr
Ringgold, GA 30736-8916
Phone (423) 260-4290

Other identifiers 1

IdentifierTypeStateIssuer
1356799688MedicaidGA

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
LPN083786GAMDLicensed Practical Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1474416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474416000000",
    "number": "1245788017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "538 SPRING MEADOWS DR",
            "city": "RINGGOLD",
            "state": "GA",
            "postal_code": "307368916",
            "telephone_number": "423-260-4290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4083 CLOUD SPRINGS RD",
            "city": "RINGGOLD",
            "state": "GA",
            "postal_code": "307368411",
            "telephone_number": "706-820-6087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SISEMORE",
        "first_name": "LAUREN",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-21",
        "last_updated": "2016-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "GA",
            "license": "LPN083786",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1356799688",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ringgold, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 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.

Verify at the official NPI Registry.