Active NPI
Lori Ann Wilson, PH.D
- Clinical Neuropsychologist
- Atlanta, GA
National Provider Identifier
1447430830
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Neuropsychologist
- License
- PSY0002210
- Practice address
- 4549 Chamblee Dunwoody Rd
Atlanta, GA 30338-6210 - Phone
- (770) 677-9300
- Fax
- (770) 677-9400
- NPI assigned
- Nov 14, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Neuropsychologist | 103G00000X | PSY0002210 | GA | Primary |
Addresses
Primary practice location
4549 Chamblee Dunwoody Rd
Atlanta, GA 30338-6210
Mailing address
4549 Chamblee Dunwoody Rd
Atlanta, GA 30338-6210
Phone (770) 677-9300
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY0002210 | GA | MD | Clinical Neuropsychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1194998400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1194998400000",
"number": "1447430830",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4549 CHAMBLEE DUNWOODY RD",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303386210",
"telephone_number": "770-677-9300",
"fax_number": "770-677-9400"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4549 CHAMBLEE DUNWOODY RD",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303386210",
"telephone_number": "770-677-9300",
"fax_number": "770-677-9400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "LORI",
"middle_name": "ANN",
"credential": "PH.D",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-11-14",
"last_updated": "2007-11-14",
"status": "A"
},
"taxonomies": [
{
"code": "103G00000X",
"taxonomy_group": "",
"desc": "Clinical Neuropsychologist",
"state": "GA",
"license": "PSY0002210",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Atlanta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.