Active NPI
Allicia Edosa, NP-C
- Family Nurse Practitioner
- Washington, DC
National Provider Identifier
1306456884
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- NP500003934
- Practice address
- 1350 Connecticut Ave NW Ste 1250
Washington, DC 20036-1728 - Phone
- (202) 627-1901
- NPI assigned
- Aug 9, 2020
- 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 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | RN264232 | GA | |
| Family Nurse Practitioner | 363LF0000X | 5019317 | NC | |
| Family Nurse Practitioner | 363LF0000X | 1115651 | TX | |
| Family Nurse Practitioner | 363LF0000X | NP500003934 | DC | Primary |
Addresses
Primary practice location
1350 Connecticut Ave NW Ste 1250
Washington, DC 20036-1728
Mailing address
115 Carriage Lake Dr
Stockbridge, GA 30281-6287
Other practice location 1
4760 Austell Rd Ste 1
Austell, GA 30106-2007
Phone (770) 819-1484
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| NP500003934 | DC | MD | Family Nurse Practitioner |
| RN264232 | GA | MD | Family Nurse Practitioner |
| 5019317 | NC | MD | Family Nurse Practitioner |
| 1115651 | TX | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| D L Murray MD PC | Current | Accepting new patients | |
| Transit Home Care Consultants, LLC | Current | Accepting new patients |
Locations
920 Dannon Vw SW
Ste 3103
Atlanta, GA 30331
Phone (404) 549-9471
4760 Austell Rd
Ste 1
Austell, GA 30106
Phone (404) 549-9471
3626 Old Oakwood Rd
Oakwood, GA 30566
Phone (770) 287-8953
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.
-
- Family Medicine Physician
- Atlanta, GA
- NPI 1720379696
-
- Primary Care Nurse Practitioner
- Atlanta, GA
- NPI 1548843006
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1596931200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1709164800000",
"number": "1306456884",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "115 CARRIAGE LAKE DR",
"city": "STOCKBRIDGE",
"state": "GA",
"postal_code": "302816287"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1350 CONNECTICUT AVE NW STE 1250",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200361728",
"telephone_number": "202-627-1901"
}
],
"practiceLocations": [
{
"address_1": "4760 Austell Rd Ste 1",
"address_purpose": "LOCATION",
"city": "Austell",
"state": "GA",
"postal_code": "301062007",
"country_code": "US",
"telephone_number": "770-819-1484",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "EDOSA",
"first_name": "ALLICIA",
"credential": "NP-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-08-09",
"last_updated": "2024-02-29",
"certification_date": "2024-02-29",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "GA",
"license": "RN264232",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "NC",
"license": "5019317",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "TX",
"license": "1115651",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "DC",
"license": "NP500003934",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Washington, DC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2024; 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.