Individual provider Active NPI

Lucinda Miles Hudson-Neeley

  • Family Nurse Practitioner
  • Carrollton, GA
National Provider Identifier
1366945404
Registry record updated Mar 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN219876 Issued in GA
Practice address
1355 S Park St
Carrollton, GA 30117-4433
Phone
(678) 664-3293
Fax
(678) 664-3294
NPI assigned
Mar 15, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2025

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 RN219876 GA Primary

Addresses

Primary practice location

1355 S Park St
Carrollton, GA 30117-4433

Mailing address

PO Box 932958
Cleveland, OH 44193-0028

Other practice location 1

4039 Atlanta St
Powder Springs, GA 30127-2666
Phone (770) 739-1200

Other names 1

  • Luci Miles Hudson-Neeley Other name

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
I20210205001329 GA Practitioner - Nurse Practitioner 3274947007

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

40 S Main St
Ste1300
Memphis, TN 38103-5513

4039 Atlanta St
Powder Springs, GA 30127-2966

702 SW 8TH St
Bentonville, AR 72716-0445

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
TLC of Georgia LLC Family CurrentSince Jul 31, 2023 Accepting new patients

Locations

1355 S Park St
Carrollton, GA 30117
Phone (678) 664-3293

455 Nathan Dean Blvd
Dallas, GA 30132
Phone (770) 443-8776

3600 Dallas Hwy SW
Marietta, GA 30064
Phone (770) 420-9170

564 Crosstown Dr
Peachtree Cty, GA 30269
Phone (770) 282-2944

Interoperability endpoints

  • Direct secure messaging: ms_lhudso27@landmarkhealth-direct.org

Organizations & group practices 1

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": "1521072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742169600000",
    "number": "1366945404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 932958",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441930028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1355 S PARK ST",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301174433",
            "telephone_number": "678-664-3293",
            "fax_number": "678-664-3294"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4039 Atlanta St",
            "address_purpose": "LOCATION",
            "city": "Powder Springs",
            "state": "GA",
            "postal_code": "301272666",
            "country_code": "US",
            "telephone_number": "770-739-1200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HUDSON-NEELEY",
        "first_name": "LUCINDA",
        "middle_name": "MILES",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-15",
        "last_updated": "2025-03-17",
        "certification_date": "2025-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN219876",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LUCI",
            "last_name": "HUDSON-NEELEY",
            "middle_name": "MILES",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Carrollton, GA

Sources for this page

Verify at the official NPI Registry.