NPIMap

Individual provider Active NPI

Nicole Treadway, MD

  • Internal Medicine Physician
  • Decatur, GA
National Provider Identifier
1306305685
Registry record updated Apr 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
92237 Issued in GA
Practice address
3527 Memorial Dr Unit W
Decatur, GA 30032-2731
Phone
(404) 573-4844
Fax
(415) 252-7176
NPI assigned
Mar 18, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 92237 GA Primary

Addresses

Primary practice location

3527 Memorial Dr Unit W
Decatur, GA 30032-2731

Mailing address

1 Embarcadero Ctr FL 19
San Francisco, CA 94111-3628

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220903000130 GA Practitioner - Internal Medicine 1153658109 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Emory University School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Grady Memorial Hospital CorporationGroup PAC ID 7517032998, 365 clinicians

Practice addresses (Care Compare)

80 Jesse Hill Jr Dr SE
Atlanta, GA 30303-3050
Phone (404) 616-8880

Hospital & facility affiliations

  • Grady Memorial Hospital Hospital, Atlanta, GA, CCN 110079

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Iora Senior Health, LLC Internal Medicine CurrentSince Sep 12, 2022 Accepting new patients
Grady Memorial Hospital Corporation CurrentSince Jun 1, 2025 Accepting new patients
Iora Senior Health, LLC Internal Medicine Current Accepting new patients
Iora Senior Health, LLC Internal Medicine CurrentSince Sep 12, 2022 Accepting new patients
Grady Memorial Hospital Corporation Internal Medicine CurrentSince Jun 1, 2025 Accepting new patients
Grady Memorial Hospital Corporation Past Accepting new patients
Iora Health Massachusetts, P.C. Internal Medicine Past Accepting new patients
Iora Health, LLC Internal Medicine Past Accepting new patients

Locations

1 Embarcadero Ctr
Fl 19
San Francisco, CA 94111
Phone (415) 814-0927

80 Jesse Hill Jr Dr SE
Atlanta, GA 30303
Phone (404) 616-4370

80 Jesse Hill Jr Dr SE
#26019
Atlanta, GA 30303
Phone (404) 616-2219

4007 Flat Shoals Pkwy
Decatur, GA 30034
Phone (404) 616-5711

3527 Memorial Dr
Unit W
Decatur, GA 30032
Phone (404) 573-4844

1 Lincoln St
Fl 24
Boston, MA 02111

Organizations & group practices 12

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1552867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744934400000",
    "number": "1306305685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 EMBARCADERO CTR FL 19",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941113628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3527 MEMORIAL DR UNIT W",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300322731",
            "telephone_number": "404-573-4844",
            "fax_number": "415-252-7176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TREADWAY",
        "first_name": "NICOLE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-18",
        "last_updated": "2025-04-18",
        "certification_date": "2025-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "92237",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, GA

Sources for this page

Verify at the official NPI Registry.