Active NPI
Lani Harrell, PA-C
- Surgical Physician Assistant
- Dahlonega, GA
National Provider Identifier
1639221575
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Physician Assistant
- License
- 003663
- Practice address
- 64 Mountain Dr
Dahlonega, GA 30533-1601 - Phone
- (706) 864-6196
- Fax
- (706) 867-0729
- NPI assigned
- Jan 18, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Physician Assistant | 363AS0400X | 003663 | GA | Primary |
Addresses
Primary practice location
64 Mountain Dr
Dahlonega, GA 30533-1601
Mailing address
64 Mountain Dr
Dahlonega, GA 30533-1601
Phone (706) 864-6196
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)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 003663 | GA | MD | Surgical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169078400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1639221575",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "64 MOUNTAIN DR",
"city": "DAHLONEGA",
"state": "GA",
"postal_code": "305331601",
"telephone_number": "706-864-6196",
"fax_number": "709-867-0729"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "64 MOUNTAIN DR",
"city": "DAHLONEGA",
"state": "GA",
"postal_code": "305331601",
"telephone_number": "706-864-6196",
"fax_number": "706-867-0729"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARRELL",
"first_name": "LANI",
"credential": "PA-C",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-18",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "GA",
"license": "003663",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dahlonega, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.