Individual provider Active NPI

Clarissa Diann Burns, NP

  • Nurse Practitioner
  • Atlanta, GA
National Provider Identifier
1568092518
Registry record updated Jul 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN207030 Issued in GA
Practice address
1055 Howell Mill Rd NW FL 8
Atlanta, GA 30318-5557
Phone
(866) 849-0692
NPI assigned
Jan 17, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 6, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN207030 GA Primary
Family Medicine Physician 207Q00000X RN207030 GA
Nurse Practitioner 363L00000X 32099 SC
Nurse Practitioner 363L00000X 5024431 NC

Addresses

Primary practice location

1055 Howell Mill Rd NW FL 8
Atlanta, GA 30318-5557

Mailing address

245 Juliet Dr
Hampton, GA 30228-4834

Other practice location 1

176 Lyons St
Jackson, GA 30233-2134
Phone (404) 688-1350

Other practice location 2

80 Vinings Dr
McDonough, GA 30253-5994
Phone (770) 302-6780

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
I20220909002947 GA Practitioner - Nurse Practitioner 5991180036 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Piedmont Medical Care CorporationGroup PAC ID 6002802220, 368 clinicians

Practice addresses (Care Compare)

80 Vinings Dr
McDonough, GA 30253-5994
Phone (770) 302-6780

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN207030GAMDNurse Practitioner
5024431NCMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southside Medical Center, Inc CurrentSince Jun 1, 2022 Accepting new patients
Piedmont Medical Care Corporation Family Medicine CurrentSince Aug 1, 2024 Accepting new patients
MC Medical LLC Nurse Practitioner Current Accepting new patients
Southside Medical Center, Inc. CurrentSince Jun 1, 2022 Accepting new patients

Locations

105 Collier Rd NW
Ste 5020
Atlanta, GA 30309
Phone (404) 350-3860

1046 Ridge Ave SW
Atlanta, GA 30315
Phone (404) 564-6942

3615 Charles Hardy Pkwy
Ste 200
Dallas, GA 30157
Phone (770) 767-5542

125 Pavilion Pkwy
Ste A
Fayetteville, GA 30214
Phone (770) 719-0932

176 Lyons St
Jackson, GA 30233
Phone (770) 504-5566

137 Willow LN
McDonough, GA 30253
Phone (470) 483-0409

80 Vinings Dr
McDonough, GA 30253
Phone (770) 302-6780

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1579219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783296000000",
    "number": "1568092518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "245 JULIET DR",
            "city": "HAMPTON",
            "state": "GA",
            "postal_code": "302284834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1055 HOWELL MILL RD NW FL 8",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303185557",
            "telephone_number": "866-849-0692"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "176 Lyons St",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "GA",
            "postal_code": "302332134",
            "country_code": "US",
            "telephone_number": "404-688-1350",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "80 Vinings Dr",
            "address_purpose": "LOCATION",
            "city": "McDonough",
            "state": "GA",
            "postal_code": "302535994",
            "country_code": "US",
            "telephone_number": "770-302-6780",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BURNS",
        "first_name": "CLARISSA",
        "middle_name": "DIANN",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-17",
        "last_updated": "2026-07-06",
        "certification_date": "2026-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN207030",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "RN207030",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "SC",
            "license": "32099",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5024431",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.