Individual provider Active NPI

Lindsay Kelley Connors, CPNP

  • Pediatric Nurse Practitioner
  • Roswell, GA
National Provider Identifier
1437817160
Registry record updated Apr 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
RN249188 Issued in GA
Practice address
12020 Etris Rd Ste B140
Roswell, GA 30075-8013
Phone
(770) 591-9000
Fax
(404) 777-0938
NPI assigned
Nov 30, 2021
Last updated
Apr 9, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X RN249188 GA Primary

Addresses

Primary practice location

12020 Etris Rd Ste B140
Roswell, GA 30075-8013

Mailing address

12020 Etris Rd Ste B140
Roswell, GA 30075-8013
Phone (770) 591-9000

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
I20240506000200 GA Practitioner - Nurse Practitioner 0244670412 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN249188GAMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Georgia Surgical Professional Services, LLC CurrentSince Apr 24, 2024 Accepting new patients
Pediatric Associates of Lawrenceville LLC PastSince Dec 1, 2021 Accepting new patients
ENT of Georgia, LLC PastSince Apr 14, 2024 Accepting new patients

Locations

738 Old Norcross Rd
Ste 100
Lawrenceville, GA 30046
Phone (770) 495-3820

748 Old Norcross Rd
Ste 100
Lawrenceville, GA 30046
Phone (404) 297-4230

12020 Etris Rd
Ste B140
Roswell, GA 30075
Phone (770) 591-9000

1000 Johnson Ferry Rd
Sandy Springs, GA 30342
Phone (404) 851-8737

Interoperability endpoints

  • Direct secure messaging: lconnors@pal.opdirect.net

Organizations & group practices 3

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": "1638230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712620800000",
    "number": "1437817160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12020 ETRIS RD STE B140",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300758013",
            "telephone_number": "770-591-9000",
            "fax_number": "404-777-0938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12020 ETRIS RD STE B140",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300758013",
            "telephone_number": "770-591-9000",
            "fax_number": "404-777-0938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNORS",
        "first_name": "LINDSAY",
        "middle_name": "KELLEY",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-30",
        "last_updated": "2024-04-09",
        "certification_date": "2024-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "GA",
            "license": "RN249188",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roswell, GA

Sources for this page

Verify at the official NPI Registry.