Individual provider Active NPI

Lauren Holcombe, NP-C

  • Adult Health Nurse Practitioner
  • Carrollton, GA
National Provider Identifier
1487153839
Registry record updated Aug 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
216603 Issued in GA
Practice address
100 Professional PL Ste 204
Carrollton, GA 30117
Phone
(770) 834-3351
NPI assigned
Feb 12, 2018
Last updated
Aug 1, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 216603 GA Primary

Addresses

Primary practice location

100 Professional PL Ste 204
Carrollton, GA 30117

Mailing address

100 Professional PL Ste 204
Carrollton, GA 30117-3802

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
I20180711001712 GA Practitioner - Nurse Practitioner 0749536449 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Primary Care Group of West GeorgiaGroup PAC ID 6709772197, 9 clinicians

Practice addresses (Care Compare)

100 Professional PL
Suite 204
Carrollton, GA 30117-3802
Phone (770) 834-3351

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
216603GAMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Primary Care Group of West Georgia CurrentSince Mar 5, 2018 Accepting new patients

Locations

100 Professional Pl
Ste 204
Carrollton, GA 30117
Phone (770) 834-3351

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1518393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533081600000",
    "number": "1487153839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 PROFESSIONAL PL STE 204",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301173802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 PROFESSIONAL PL STE 204",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "30117",
            "telephone_number": "770-834-3351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLCOMBE",
        "first_name": "LAUREN",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-12",
        "last_updated": "2018-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "GA",
            "license": "216603",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carrollton, GA

Sources for this page

Verify at the official NPI Registry.