Individual provider Active NPI

Jerlene Lawrence

  • Family Nurse Practitioner
  • Toccoa, GA
National Provider Identifier
1457755274
Registry record updated Oct 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN161643 Issued in GA
Practice address
163 Hospital Dr
Toccoa, GA 30577-6820
Phone
(706) 886-6841
Fax
(706) 282-4460
NPI assigned
Oct 22, 2014
Last updated
Oct 22, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 22, 2014

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 RN161643 GA Primary

Addresses

Primary practice location

163 Hospital Dr
Toccoa, GA 30577-6820

Mailing address

1600 E Boggs Mountain Rd
Tiger, GA 30576-2903
Phone (706) 782-6526

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
RN161643GAMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1413936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413936000000",
    "number": "1457755274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 E BOGGS MOUNTAIN RD",
            "city": "TIGER",
            "state": "GA",
            "postal_code": "305762903",
            "telephone_number": "706-782-6526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "163 HOSPITAL DR",
            "city": "TOCCOA",
            "state": "GA",
            "postal_code": "305776820",
            "telephone_number": "706-886-6841",
            "fax_number": "706-282-4460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAWRENCE",
        "first_name": "JERLENE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-10-22",
        "last_updated": "2014-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN161643",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Toccoa, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2014; 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.