Individual provider Active NPI

Linda Linnette Payne, FNP-C

  • Family Nurse Practitioner
  • Conyers, GA
National Provider Identifier
1407568629
Registry record updated Mar 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN188390 Issued in GA
Practice address
1506 Klondike Rd SW Ste 205
Conyers, GA 30094-5173
Phone
(678) 750-4000
Fax
(678) 750-4005
NPI assigned
Dec 19, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 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 RN188390 GA Primary

Addresses

Primary practice location

1506 Klondike Rd SW Ste 205
Conyers, GA 30094-5173

Mailing address

1506 Klondike Rd SW Ste 205
Conyers, GA 30094-5173
Phone (678) 750-4000

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL 6787504005 Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
RN188390GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Center for Wellness Current Accepting new patients

Locations

1506 Klondike Rd SW
Ste 205
Conyers, GA 30094
Phone (678) 750-3010

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": "1671408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677628800000",
    "number": "1407568629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1506 KLONDIKE RD SW STE 205",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300945173",
            "telephone_number": "678-750-4000",
            "fax_number": "678-750-4005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1506 KLONDIKE RD SW STE 205",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300945173",
            "telephone_number": "678-750-4000",
            "fax_number": "678-750-4005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAYNE",
        "first_name": "LINDA",
        "middle_name": "LINNETTE",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-19",
        "last_updated": "2023-03-01",
        "certification_date": "2023-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN188390",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "6787504005",
            "affiliation": "N",
            "endpointDescription": "FAX",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Medical Records",
            "address_1": "1506 Klondike Rd SW Ste 205",
            "city": "Conyers",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300945173",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Conyers, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.