Individual provider Active NPI

Alicia C Simpson, MS, RD, LD, IBCLC

  • Registered Dietitian
  • Decatur, GA
National Provider Identifier
1306281472
Registry record updated Jun 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
LD004064 Issued in GA
Practice address
215 Church St Ste 112
Decatur, GA 30030-3330
Phone
(678) 607-6052
Fax
(404) 850-1362
NPI assigned
May 2, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Nutritionist 133N00000X LD004064 GA
Pediatric Nutrition Registered Dietitian 133VN1004X LD004064 GA
Lactation Consultant (Non-RN) 174N00000X L-46587 GA
Registered Dietitian 133V00000X LD004064 GA Primary

Addresses

Primary practice location

215 Church St Ste 112
Decatur, GA 30030-3330

Mailing address

215 Church St Ste 112
Decatur, GA 30030-3330
Phone (678) 607-6052

Other identifiers 1

IdentifierTypeStateIssuer
003137551AMedicaidGA

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
Master of Science

State licenses

LicenseStateTypeSpecialty
LD004064GAMDRegistered Dietitian
L-46587GAMDLactation Consultant (Non-RN)

Practice roles

OrganizationSpecialtyStatusNew patients
Pea Pod Nutrition and Lactation Support Dietitian, Registered CurrentSince Apr 2, 2013 Accepting new patients
Fay Nutrition Dietitian, Registered Past Accepting new patients

Locations

1164 N Highland Ave NE
Atlanta, GA 30306
Phone (404) 771-5751

1 Baltimore Pl NW
Ste 105
Atlanta, GA 30308
Phone (404) 474-2770

215 Church St
Ste 112
Decatur, GA 30030
Phone (678) 607-6052

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1367452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748908800000",
    "number": "1306281472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 CHURCH ST STE 112",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300303330",
            "telephone_number": "678-607-6052",
            "fax_number": "404-850-1362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 CHURCH ST STE 112",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300303330",
            "telephone_number": "678-607-6052",
            "fax_number": "404-850-1362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMPSON",
        "first_name": "ALICIA",
        "middle_name": "C",
        "credential": "MS, RD, LD, IBCLC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-02",
        "last_updated": "2025-06-03",
        "certification_date": "2025-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "GA",
            "license": "LD004064",
            "primary": false
        },
        {
            "code": "133VN1004X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Pediatric",
            "state": "GA",
            "license": "LD004064",
            "primary": false
        },
        {
            "code": "174N00000X",
            "taxonomy_group": "",
            "desc": "Lactation Consultant, Non-RN",
            "state": "GA",
            "license": "L-46587",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "GA",
            "license": "LD004064",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003137551A",
            "state": "GA"
        }
    ],
    "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 Jun 3, 2025; 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.