Individual provider Active NPI

Lauren Williams-Bryant, RN

  • Nurse Practitioner
  • Villa Rica, GA
National Provider Identifier
1407550981
Registry record updated Aug 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN210993 Issued in GA
Practice address
690 Dallas Hwy Ste 103
Villa Rica, GA 30180-1265
Phone
(770) 214-2800
Fax
(770) 214-2803
NPI assigned
Mar 28, 2023
Last updated
Aug 9, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 9, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN210993 GA Primary
Registered Nurse 163W00000X RN210993 GA

Addresses

Primary practice location

690 Dallas Hwy Ste 103
Villa Rica, GA 30180-1265

Mailing address

157 Clinic Ave Ste 201
Carrollton, GA 30117-4454
Phone (770) 214-2800

Other practice location 1

157 Clinic Ave Ste 201
Carrollton, GA 30117-4454
Phone (770) 214-2800

Other practice location 2

204 Allen Memorial Dr Ste 302B
Bremen, GA 30110-2047
Phone (770) 214-2800

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
I20240417000271 GA Practitioner - Nurse Practitioner 3274972765 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
West Georgia Gastroenterology Associates,PCGroup PAC ID 5890783104, 12 clinicians

Practice addresses (Care Compare)

690 Dallas Hwy 103
Villa Rica, GA 30180-1265
Phone (770) 214-2800

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN210993GAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
West Georgia Gastroenterology Associates,PC CurrentSince Jan 16, 2024 Accepting new patients
TMG Northwest Georgia Oncology Center Inc PastSince Jul 1, 2023 Accepting new patients

Locations

157 Clinic Ave
Ste 201
Carrollton, GA 30117
Phone (770) 214-2800

160 Clinic Ave
Carrollton, GA 30117
Phone (770) 214-2800

690 Dallas Hwy
Ste 103
Villa Rica, GA 30180
Phone (770) 214-2800

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1679961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723161600000",
    "number": "1407550981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "157 CLINIC AVE STE 201",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301174454",
            "telephone_number": "770-214-2800",
            "fax_number": "770-214-2803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "690 DALLAS HWY STE 103",
            "city": "VILLA RICA",
            "state": "GA",
            "postal_code": "301801265",
            "telephone_number": "770-214-2800",
            "fax_number": "770-214-2803"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "157 Clinic Ave Ste 201",
            "address_purpose": "LOCATION",
            "city": "Carrollton",
            "state": "GA",
            "postal_code": "301174454",
            "country_code": "US",
            "telephone_number": "770-214-2800",
            "fax_number": "770-214-2803",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "204 Allen Memorial Dr Ste 302B",
            "address_purpose": "LOCATION",
            "city": "Bremen",
            "state": "GA",
            "postal_code": "301102047",
            "country_code": "US",
            "telephone_number": "770-214-2800",
            "fax_number": "770-214-2803",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMS-BRYANT",
        "first_name": "LAUREN",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-03-28",
        "last_updated": "2024-08-09",
        "certification_date": "2024-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN210993",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GA",
            "license": "RN210993",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Villa Rica, GA

Sources for this page

Verify at the official NPI Registry.