Dorothy Nicole Lake, CPNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

APRN-NP213402 Issued in GA

Practice address

706 Dixie St Ste 200
Carrollton, GA 30117-3889

Phone

(770) 812-8640

Fax

(770) 838-8650

NPI assigned

Oct 2, 2015

Last updated

Oct 24, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Pediatric Nurse Practitioner, Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Tanner Medical Group Inc

  • Cardiovascular Disease Physician
  • Carrollton, GA
  • NPI 1396979787
  Medicare reassignment NPD
• 316 Family Medicine

  • Family Medicine Physician
  • Bremen, GA
  • NPI 1861915647
  Medicare reassignment
• Emergency Coverage, LLC

  dba Emergency Coverage Corporation of TeamHealth

  • Family Medicine Physician
  • Newport, TN
  • NPI 1427005008

  GA

  Medicare reassignment
• 3:16 Urgent Care LLC

  • Urgent Care Clinic/Center
  • Bremen, GA
  • NPI 1295695781
  NPD (past)
• Carrollton Surgical Group, P. a.

  • Surgery Physician
  • Carrollton, GA
  • NPI 1417931825
  NPD (past)
• Daffodil Pediatrics and Family Medicine

  • Pediatrics Physician
  • Forest Park, GA
  • NPI 1851663124
  NPD (past)
• TMC Children's Healthcare of West Georgia

  • Medical Specialty Clinic/Center
  • Carrollton, GA
  • NPI 1518972348
  NPD (past)

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

{
    "created_epoch": "1443744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761264000000",
    "number": "1528438538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "706 DIXIE ST STE 220",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301173889",
            "telephone_number": "770-812-8825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "706 DIXIE ST STE 200",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301173889",
            "telephone_number": "770-812-8640",
            "fax_number": "770-838-8650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAKE",
        "first_name": "DOROTHY",
        "middle_name": "NICOLE",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-02",
        "last_updated": "2025-10-24",
        "certification_date": "2025-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "GA",
            "license": "APRN-NP213402",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Krish, M.ED CCC-SLP
• Mary Kate Kuchinski
• Nelson Kevin Tanefo Kuete, MD
• Mark Alan Kunkel, PH.D.
• Kisha Lafleur, MD
• Kim M Lambert, CRNA
• Paige Diane Lambert, M.A., CCC-A
• Tiffany Landry
• Guy Harris Langlo, DPM
• Amy Rogers Lanier, MASTERS IN SPEECH LA

• Pediatric Nurse Practitioner in Carrollton, GA
• Providers in Carrollton, GA by specialty
• Pediatric Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.