Individual provider Active NPI

Douglas Cox, FNP-C

  • Family Nurse Practitioner
  • Douglasville, GA
National Provider Identifier
1710369012
Registry record updated Jun 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN206906 Issued in GA
Practice address
2022 Fairburn Rd
Suite D
Douglasville, GA 30135-1062
Phone
(770) 942-1044
Fax
(770) 942-1699
NPI assigned
Jun 23, 2015
Last updated
Jun 23, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2015

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 RN206906 GA Primary

Addresses

Primary practice location

2022 Fairburn Rd
Suite D
Douglasville, GA 30135-1062

Mailing address

2022 Fairburn Rd
Suite D
Douglasville, GA 30135-1062
Phone (770) 942-1044

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
I20151030001873 GA Practitioner - Nurse Practitioner 4082924246 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5041 Dallas Hwy
Suite G
Powder Springs, GA 30127-6458
Phone (855) 722-3563

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN206906GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
L&D Medical Center, LLC Family CurrentSince Aug 1, 2020 Accepting new patients
Back to Life Medical Group, LLC CurrentSince Oct 21, 2018 Accepting new patients

Locations

557 Riverstone Pkwy
Canton, GA 30114
Phone (770) 345-4520

557 Riverstone Pkwy
Ste 100
Canton, GA 30114
Phone (770) 345-4520

557 Riverstone Pkwy
Ste 140
Canton, GA 30114
Phone (678) 552-6294

5041 Dallas Hwy
Ste G
Powder Springs, GA 30127
Phone (404) 542-3886

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1435017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435017600000",
    "number": "1710369012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2022 FAIRBURN RD",
            "address_2": "SUITE D",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301351062",
            "telephone_number": "770-942-1044",
            "fax_number": "770-942-1699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2022 FAIRBURN RD",
            "address_2": "SUITE D",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301351062",
            "telephone_number": "770-942-1044",
            "fax_number": "770-942-1699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COX",
        "first_name": "DOUGLAS",
        "name_prefix": "Mr.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-23",
        "last_updated": "2015-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN206906",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Douglasville, GA

Sources for this page

Verify at the official NPI Registry.