Organization Active NPI

Family Practice Immediate Care Associate Limited Liability Company

  • Family Nurse Practitioner
  • Covington, GA
National Provider Identifier
1598560443
Registry record updated Mar 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
FAMILY PRACTICE IMMEDIATE CARE ASSOCIATE LIMITED LIABILITY COMPANY
Practice address
3812 Salem Rd
Covington, GA 30016-4528
Phone
(678) 625-5431
Fax
(678) 625-5455
NPI assigned
Feb 14, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2025

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

Authorized official

Name
Margaret Blanche Lyons, FNPNPI 1831733088
Title
Owner
Phone
(678) 558-2638

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

3812 Salem Rd
Covington, GA 30016-4528

Mailing address

3812 Salem Rd
Covington, GA 30016-4528
Phone (678) 625-5431

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250325001270 GA Part B Supplier - Clinic/Group Practice 5991228538 Receives reassigned benefits from 1 practitioner
Practice locations: Covington, GA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D2321197Family Practice Immediate Care Associate LLC3812 Salem Road, Covington, GA 30016Certificate of waiverMar 31, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1739491200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742342400000",
    "number": "1598560443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3812 SALEM RD",
            "city": "COVINGTON",
            "state": "GA",
            "postal_code": "300164528",
            "telephone_number": "678-625-5431",
            "fax_number": "678-625-5455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3812 SALEM RD",
            "city": "COVINGTON",
            "state": "GA",
            "postal_code": "300164528",
            "telephone_number": "678-625-5431",
            "fax_number": "678-625-5455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY PRACTICE IMMEDIATE CARE ASSOCIATE LIMITED LIABILITY COMPANY",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-14",
        "last_updated": "2025-03-19",
        "certification_date": "2025-03-19",
        "status": "A",
        "authorized_official_last_name": "LYONS",
        "authorized_official_first_name": "MARGARET",
        "authorized_official_middle_name": "BLANCHE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "678-558-2638",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Covington, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.