Individual provider Active NPI

Amy D Whitcomb, LPN

  • Licensed Practical Nurse
  • Woodstock, GA
National Provider Identifier
1750174470
Registry record updated May 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
LPN102126 Issued in GA
Practice address
270 Heritage Walk
Woodstock, GA 30188-3875
Phone
(678) 494-5700
Fax
(678) 494-5703
NPI assigned
May 26, 2025
Last updated
May 26, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 26, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X LPN102126 GA Primary

Addresses

Primary practice location

270 Heritage Walk
Woodstock, GA 30188-3875

Mailing address

1515 Oak Creek Dr
Marietta, GA 30066-4159
Phone (770) 851-1146

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LPN102126GAMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Woodstock Treatment Center LLC CurrentSince Jun 3, 2025 Accepting new patients
Georgia CTC, LLC PastSince Jun 3, 2025 Accepting new patients

Locations

270 Heritage Walk
Woodstock, GA 30188
Phone (678) 494-5700

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": "1748217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748217600000",
    "number": "1750174470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 OAK CREEK DR",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300664159",
            "telephone_number": "770-851-1146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "270 HERITAGE WALK",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301883875",
            "telephone_number": "678-494-5700",
            "fax_number": "678-494-5703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITCOMB",
        "first_name": "AMY",
        "middle_name": "D",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-05-26",
        "last_updated": "2025-05-26",
        "certification_date": "2025-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "GA",
            "license": "LPN102126",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodstock, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.