Individual provider Active NPI

Lauren Thornton, FNP

  • Family Nurse Practitioner
  • Blackshear, GA
National Provider Identifier
1306498548
Registry record updated Jul 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN170290 Issued in GA
Practice address
120 E Carter Ave
Blackshear, GA 31516-1561
Phone
(912) 449-4426
Fax
(912) 449-1059
NPI assigned
Jul 9, 2019
Last updated
Jul 9, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN170290 GA Primary

Addresses

Primary practice location

120 E Carter Ave
Blackshear, GA 31516-1561

Mailing address

4362 Meadow Wood Rd
Blackshear, GA 31516-4519

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
I20191007001696 GA Practitioner - Nurse Practitioner 9830420892 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Acs Primary Care Physicians - Southeast PCGroup PAC ID 5193620714, 409 clinicians

Practice addresses (Care Compare)

1900 Tebeau St
Waycross, GA 31501-6357
Phone (912) 283-3030

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group of Georgia LLC CurrentSince Aug 6, 2019 Accepting new patients
Privia Medical Group of Georgia LLC CurrentSince Aug 6, 2019 Accepting new patients
St Vincents Ambulatory Care Inc CurrentSince Dec 10, 2021 Accepting new patients
Peachtree Immediate Care FP, LLC CurrentSince Oct 28, 2022 Accepting new patients
St Vincents Ambulatory Care Inc CurrentSince Dec 10, 2021 Accepting new patients
St Vincent's Full Service Urgent Care, LLC CurrentSince Sep 28, 2021 Accepting new patients
Acs Primary Care Physicians - Southeast PC CurrentSince Sep 1, 2024 Accepting new patients

Locations

4205 Belfort Rd
Ste 4015
Jacksonville, FL 32216
Phone (904) 296-5691

120 E Carter Ave
Blackshear, GA 31516
Phone (912) 449-4426

120 E Carter Ave
Ste A
Blackshear, GA 31516
Phone (912) 449-4426

101 Yorktown Dr
Ste 100
Fayetteville, GA 30214
Phone (770) 460-4285

590 Lanier Ave W
Fayetteville, GA 30214

3827 Jimmy Lee Smith Pkwy
Hiram, GA 30141
Phone (770) 222-8900

1481 Highway 40 E
Kingsland, GA 31548
Phone (912) 576-6865

2151 W Spring St
Monroe, GA 30655
Phone (770) 267-1792

1506 Alice St
Waycross, GA 31501
Phone (912) 285-3086

1900 Tebeau St
Waycross, GA 31501
Phone (912) 283-3030

615 Pendleton St
Waycross, GA 31501
Phone (912) 285-9994

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8042/brand/1/csg/1/fhir/r4

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1562630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562630400000",
    "number": "1306498548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4362 MEADOW WOOD RD",
            "city": "BLACKSHEAR",
            "state": "GA",
            "postal_code": "315164519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 E CARTER AVE",
            "city": "BLACKSHEAR",
            "state": "GA",
            "postal_code": "315161561",
            "telephone_number": "912-449-4426",
            "fax_number": "912-449-1059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THORNTON",
        "first_name": "LAUREN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-09",
        "last_updated": "2019-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN170290",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Blackshear, GA

Sources for this page

Verify at the official NPI Registry.