Individual provider Active NPI

Lorraine A Smith, FNP-C

  • Family Medicine Physician
  • Snellville, GA
National Provider Identifier
1487139184
Registry record updated Sep 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
F09180144 Issued in GA
Practice address
3121 Grundy Ives Dr
Snellville, GA 30039-3610
Phone
(678) 507-4688
Fax
(678) 639-3333
NPI assigned
Sep 27, 2018
Last updated
Sep 27, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X F09180144 GA Primary

Addresses

Primary practice location

3121 Grundy Ives Dr
Snellville, GA 30039-3610

Mailing address

3121 Grundy Ives Dr
Snellville, GA 30039-3610
Phone (678) 507-4688

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
F09180144GAMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1538006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538006400000",
    "number": "1487139184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3121 GRUNDY IVES DR",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300393610",
            "telephone_number": "678-507-4688",
            "fax_number": "678-639-3333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3121 GRUNDY IVES DR",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300393610",
            "telephone_number": "678-507-4688",
            "fax_number": "678-639-3333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "LORRAINE",
        "middle_name": "A",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-27",
        "last_updated": "2018-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "F09180144",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Snellville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2018; 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.