Individual provider Active NPI

Marie-Lyne Vaudran

  • Registered Nurse
  • Decatur, GA
National Provider Identifier
1295145175
Registry record updated May 1, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN133398 Issued in GA
Practice address
445 Winn Way
Suite 150
Decatur, GA 30030-1707
Phone
(404) 294-3813
Fax
(404) 508-7844
NPI assigned
May 1, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN133398 GA Primary

Addresses

Primary practice location

445 Winn Way
Suite 150
Decatur, GA 30030-1707

Mailing address

445 Winn Way
Suite 150
Decatur, GA 30030-1707
Phone (404) 294-3813

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
RN133398GAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Dekalb County Board of Health 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.

NPI Registry JSON

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

{
    "created_epoch": "1398902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398902400000",
    "number": "1295145175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "445 WINN WAY",
            "address_2": "SUITE 150",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300301707",
            "telephone_number": "404-294-3813",
            "fax_number": "404-508-7844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "445 WINN WAY",
            "address_2": "SUITE 150",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300301707",
            "telephone_number": "404-294-3813",
            "fax_number": "404-508-7844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAUDRAN",
        "first_name": "MARIE-LYNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-01",
        "last_updated": "2014-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GA",
            "license": "RN133398",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2014; 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.