Individual provider Active NPI

Renee C Lindsay, PA-C

  • Medical Physician Assistant
  • Peachtree City, GA
National Provider Identifier
1659601383
Registry record updated Apr 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
003254 Issued in GA
Practice address
1401 Georgian Park Ste 200
Peachtree City, GA 30269-6974
Phone
(770) 632-8908
Fax
(770) 632-6175
NPI assigned
Dec 31, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 003254 GA Primary

Addresses

Primary practice location

1401 Georgian Park Ste 200
Peachtree City, GA 30269-6974

Mailing address

1401 Georgian Park
Peachtree City, GA 30269-6973
Phone (770) 632-8908

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
I20191211000492 GA Practitioner - Physician Assistant 2961835632

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
003254GAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Peachtree City Physicians Group CurrentSince Aug 28, 2019 Accepting new patients

Locations

1401 Georgian Park
Ste 200
Peachtree City, GA 30269
Phone (770) 632-8909

Organizations & group practices 1

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": "1262217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650844800000",
    "number": "1659601383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 GEORGIAN PARK",
            "city": "PEACHTREE CITY",
            "state": "GA",
            "postal_code": "302696973",
            "telephone_number": "770-632-8908",
            "fax_number": "770-632-6175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 GEORGIAN PARK STE 200",
            "city": "PEACHTREE CITY",
            "state": "GA",
            "postal_code": "302696974",
            "telephone_number": "770-632-8908",
            "fax_number": "770-632-6175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LINDSAY",
        "first_name": "RENEE",
        "middle_name": "C",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-12-31",
        "last_updated": "2022-04-25",
        "certification_date": "2022-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": "003254",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peachtree City, GA

Sources for this page

Verify at the official NPI Registry.