Individual provider Active NPI

Julienne Kalombo Thomas, FNP

  • Family Nurse Practitioner
  • Lawrenceville, GA
National Provider Identifier
1639657620
Registry record updated Nov 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN237797 Issued in GA
Practice address
771 Old Norcross Rd
Lawrenceville, GA 30046-4386
Phone
(770) 923-4433
NPI assigned
Aug 1, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN237797 GA Primary

Addresses

Primary practice location

771 Old Norcross Rd
Lawrenceville, GA 30046-4386

Mailing address

770 Old Norcross Rd
Lawrenceville, GA 30046-4318
Phone (770) 923-4433

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, OR2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20181008001934 GA Practitioner - Nurse Practitioner 4880946573 Reassigns benefits to 3 organizations
I20260508000896 OR Practitioner - Nurse Practitioner 4880946573 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Restored Health and WellnessGroup PAC ID 3072004696, 4 clinicians

Practice addresses (Care Compare)

483 Indian Trail Lilburn Rd NW
Lilburn, GA 30047-3717
Phone (770) 923-4433

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN237797GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
D L Murray MD PC CurrentSince Oct 1, 2020 Accepting new patients
Restored Health Inc. CurrentSince Aug 1, 2018 Accepting new patients
Restored Health & Wellness CurrentSince Aug 4, 2025 Accepting new patients
Transit Home Care Consultants, LLC CurrentSince Nov 27, 2022 Accepting new patients

Locations

920 Dannon Vw SW
Ste 3103
Atlanta, GA 30331
Phone (404) 549-9471

4760 Austell Rd
Ste 1
Austell, GA 30106
Phone (404) 549-9471

771 Old Norcross Rd
Lawrenceville, GA 30046
Phone (404) 778-6590

771 Old Norcross Rd
Ste 375
Lawrenceville, GA 30046
Phone (770) 923-4433

483 Indian Trl Lilburn Rd NW
#R
Lilburn, GA 30047
Phone (770) 923-4433

483 Indian Trl Lilburn Rd NW
Lilburn, GA 30047
Phone (770) 279-2427

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": "1533081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635811200000",
    "number": "1639657620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "770 OLD NORCROSS RD",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300464318",
            "telephone_number": "770-923-4433",
            "fax_number": "770-979-5162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "771 OLD NORCROSS RD",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300464386",
            "telephone_number": "770-923-4433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "JULIENNE",
        "middle_name": "KALOMBO",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-01",
        "last_updated": "2021-11-02",
        "certification_date": "2021-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN237797",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceville, GA

Sources for this page

Verify at the official NPI Registry.