Individual provider Active NPI

Michela Nelson, FNP-BC

  • Family Nurse Practitioner
  • Douglasville, GA
National Provider Identifier
1356124077
Registry record updated Aug 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN258829 Issued in GA
Practice address
6031 Fairburn Rd
Douglasville, GA 30134-2307
Phone
(770) 942-9214
NPI assigned
Aug 16, 2023
Last updated
Aug 16, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2023

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 RN258829 GA Primary

Addresses

Primary practice location

6031 Fairburn Rd
Douglasville, GA 30134-2307

Mailing address

6031 Fairburn Rd
Douglasville, GA 30134-2307
Phone (770) 942-9214

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
I20230929003308 GA Practitioner - Nurse Practitioner 5991159550 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Upperline Healthcare PCGroup PAC ID 4385900653, 194 clinicians
Village Podiatry Group II LLCGroup PAC ID 7719218437, 70 clinicians

Practice addresses (Care Compare)

1505 Professional CT
Dalton, GA 30720-2500
Phone (706) 259-6882

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Lifetime Family Medicine,LLC CurrentSince Oct 21, 2024 Accepting new patients
Upperline Healthcare, PC CurrentSince Jan 26, 2026 Accepting new patients
Village Podiatry Group II, LLC. CurrentSince Jan 26, 2026 Accepting new patients
Upperline Healthcare, PC CurrentSince Jan 26, 2026 Accepting new patients
Village Podiatry Group II, LLC. CurrentSince Jan 26, 2026 Accepting new patients
Temple Medical LLC PastSince Oct 21, 2024 Accepting new patients

Locations

2045 Peachtree Rd NE
Ste 810
Atlanta, GA 30309
Phone (404) 351-0770

7869 Villa Rica Hwy
Dallas, GA 30157
Phone (770) 456-3333

1505 Professional Ct
Dalton, GA 30720
Phone (706) 259-6882

431 Sage St
Temple, GA 30179
Phone (770) 562-9007

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/1369/brand/1/csg/1/fhir/r4
  • Direct secure messaging: michela.nelson.1@1369.direct.athenahealth.com

Organizations & group practices 8

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": "1692144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692144000000",
    "number": "1356124077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6031 FAIRBURN RD",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301342307",
            "telephone_number": "770-942-9214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6031 FAIRBURN RD",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301342307",
            "telephone_number": "770-942-9214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "MICHELA",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-16",
        "last_updated": "2023-08-16",
        "certification_date": "2023-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN258829",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Douglasville, GA

Sources for this page

Verify at the official NPI Registry.