Active NPI
Susan R Colgrove, CRNP
- Nurse Practitioner
- Lagrange, GA
National Provider Identifier
1285614875
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- RN019428 NP
- Practice address
- 1805 Vernon Rd
Suite B
Lagrange, GA 30240-4041 - Phone
- (706) 884-2691
- Fax
- (706) 845-7314
- NPI assigned
- Jan 19, 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 |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | RN019428 NP | GA | Primary |
Addresses
Primary practice location
1805 Vernon Rd
Suite B
Lagrange, GA 30240-4041
Mailing address
1805 Vernon Rd
Suite B
Lagrange, GA 30240-4041
Phone (706) 884-2691
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)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN019428 NP | GA | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southern Center for Orthopedics | Past | Accepting new patients |
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.
-
- Orthopaedic Surgery Physician
- Lagrange, GA
- NPI 1073654489
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137628800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1285614875",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1805 VERNON RD",
"address_2": "SUITE B",
"city": "LAGRANGE",
"state": "GA",
"postal_code": "302404041",
"telephone_number": "706-884-2691",
"fax_number": "706-845-7314"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1805 VERNON RD",
"address_2": "SUITE B",
"city": "LAGRANGE",
"state": "GA",
"postal_code": "302404041",
"telephone_number": "706-884-2691",
"fax_number": "706-845-7314"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLGROVE",
"first_name": "SUSAN",
"middle_name": "R",
"name_prefix": "Mrs.",
"credential": "CRNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-01-19",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "GA",
"license": "RN019428 NP",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lagrange, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.