Individual provider Active NPI

Nanette Locole Spencer, FNP

  • Family Nurse Practitioner
  • Canton, GA
National Provider Identifier
1669140281
Registry record updated Mar 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN250345 Issued in GA
Practice address
6613 Hickory Flat Hwy
Canton, GA 30115-7237
Phone
(770) 268-4357
Fax
(470) 251-6064
NPI assigned
Aug 30, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 5, 2025

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 RN250345 GA Primary

Addresses

Primary practice location

6613 Hickory Flat Hwy
Canton, GA 30115-7237

Mailing address

3333 Riverwood Pkwy SE Ste 250
Atlanta, GA 30339-3304
Phone (770) 914-0016

Other practice location 1

643 Main St
Palmetto, GA 30268-1138
Phone (770) 463-4644

Other identifiers 1

IdentifierTypeStateIssuer
003261978CMedicaidGA

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
I20220404000056 GA Practitioner - Nurse Practitioner 4385030246 Reassigns benefits to 2 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
Aylo Health, LLCGroup PAC ID 8022901925, 112 clinicians

Practice addresses (Care Compare)

6613 Hickory Flat Hwy
Canton, GA 30115-7237
Phone (770) 914-0116

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN250345GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Aylo Health, LLC CurrentSince Mar 1, 2025 Accepting new patients
Southside Medical Center, Inc. CurrentSince Jul 18, 2022 Accepting new patients
Aylo Health, LLC CurrentSince Mar 1, 2025 Accepting new patients
Southside Medical Center, Inc CurrentSince Jul 18, 2022 Accepting new patients
Aylo Health, LLC Current Accepting new patients
Aylo Health, LLC Past Accepting new patients
Aylo Health, LLC Past Accepting new patients

Locations

3333 Riverwood Pkwy SE
Ste 250
Atlanta, GA 30339
Phone (770) 914-0016

8111 Ball Ground Hwy
Ball Ground, GA 30107
Phone (770) 268-4011

6613 Hickory Flat Hwy
Canton, GA 30115
Phone (770) 268-4357

3290 Sixes Rd
Canton, GA 30114
Phone (678) 374-7514

204 Dawson Village Way S
Dawsonville, GA 30534
Phone (706) 216-2101

2985 Mack Dobbs Rd NW
Kennesaw, GA 30152
Phone (770) 268-4011

145 Eagles Walk
Ste A
Stockbridge, GA 30281
Phone (770) 389-3855

7710 McGinnis Ferry Rd
Suwanee, GA 30024
Phone (770) 268-4361

604 Lovejoy Ln
Ste 100
Woodstock, GA 30189
Phone (770) 268-4336

604 Lovejoy Ln
Ste 200
Woodstock, GA 30189
Phone (770) 268-4011

Organizations & group practices 7

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": "1630281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741132800000",
    "number": "1669140281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 RIVERWOOD PKWY SE STE 250",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303393304",
            "telephone_number": "770-914-0016",
            "fax_number": "770-955-4278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6613 HICKORY FLAT HWY",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301157237",
            "telephone_number": "770-268-4357",
            "fax_number": "470-251-6064"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "643 Main St",
            "address_purpose": "LOCATION",
            "city": "Palmetto",
            "state": "GA",
            "postal_code": "302681138",
            "country_code": "US",
            "telephone_number": "770-463-4644",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SPENCER",
        "first_name": "NANETTE",
        "middle_name": "LOCOLE",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-30",
        "last_updated": "2025-03-05",
        "certification_date": "2025-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN250345",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003261978C",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, GA

Sources for this page

Verify at the official NPI Registry.