Andrea Elaine Ricketts, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

119715 Issued in GA

Practice address

2000 Riverside Pkwy Ste 107
Lawrenceville, GA 30043-5926

Phone

(404) 405-2321

Fax

(678) 623-0904

NPI assigned

Jun 17, 2013

Last updated

Oct 31, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Peachtree Hospice of Georgia, LLC

  • Community Based Hospice Care Agency
  • Stockbridge, GA
  • NPI 1043632334
  NPD (past)
• SB Healthcare, LLC

  dba BridgeWay Palliative Care

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Lawrenceville, GA
  • NPI 1235669045
  NPD (past)

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

{
    "created_epoch": "1371427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572480000000",
    "number": "1275972978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 RIVERSIDE PKWY STE 107",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300435926",
            "telephone_number": "404-405-2321",
            "fax_number": "770-698-9775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 RIVERSIDE PKWY STE 107",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300435926",
            "telephone_number": "404-405-2321",
            "fax_number": "678-623-0904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICKETTS",
        "first_name": "ANDREA",
        "middle_name": "ELAINE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-17",
        "last_updated": "2019-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "119715",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Danielle Richardson
• Shemeah Richardson, M.S. M. ED
• Tiffany B Richey, NP
• Melanie Nicole Richmond, LPC
• Carol Rickaby
• Rachel Elizabeth Rider, BCBA
• Fatima Rigaud-Waite
• Carye Michah Riley, DDS
• Labake Riley
• Marcia Glenn Riley, M. D.

• Family Nurse Practitioner in Lawrenceville, GA
• Providers in Lawrenceville, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.