Individual provider Active NPI

Allicia Edosa, NP-C

  • Family Nurse Practitioner
  • Washington, DC
National Provider Identifier
1306456884
Registry record updated Feb 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
NP500003934 Issued in DC
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

Updated by the provider on Feb 29, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230301000565 GA Practitioner - Nurse Practitioner 6305219957 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
NP500003934DCMDFamily Nurse Practitioner
RN264232GAMDFamily Nurse Practitioner
5019317NCMDFamily Nurse Practitioner
1115651TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
D L Murray MD PC CurrentSince Oct 19, 2022 Accepting new patients
Transit Home Care Consultants, LLC CurrentSince Nov 27, 2022 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.

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

Verify at the official NPI Registry.