Individual provider Active NPI

Angelique Lacavera, DNP-FNP-BC

  • Family Nurse Practitioner
  • Austell, GA
National Provider Identifier
1760071484
Registry record updated Aug 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN-AP257986 Issued in GA
Practice address
800 E West Connector
Austell, GA 30106-1358
Phone
(770) 438-1680
NPI assigned
Jan 17, 2021
Last updated
Aug 21, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 21, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Registered Nurse 163WG0000X RN257986 GA
Family Nurse Practitioner 363LF0000X APRN-AP257986 GA Primary

Addresses

Primary practice location

800 E West Connector
Austell, GA 30106-1358

Mailing address

209 Cooley Dr Ste 100
Villa Rica, GA 30180-7057
Phone (770) 456-0911

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
I20210908001904 GA Practitioner - Nurse Practitioner 6002212545 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Peachtree Immediate Care FP, LLCGroup PAC ID 3274559323, 328 clinicians

Practice addresses (Care Compare)

209 Cooley Dr
Suite 101
Villa Rica, GA 30180-7057
Phone (770) 456-0911

Merit-based Incentive Payment System (MIPS)

Final score
94.51 of 100Reported as apm
Quality
80.61
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
77.37 of 100Reported as group
Quality
74
Improvement activities
40
Cost
72.24

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APRN-AP257986GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Peachtree Immediate Care FP, LLC CurrentSince Jul 1, 2023 Accepting new patients

Locations

1275 Highway 54 W
Ste 201
Fayetteville, GA 30214
Phone (770) 461-3776

590 Lanier Ave W
Fayetteville, GA 30214

3827 Jimmy Lee Smith Pkwy
Hiram, GA 30141
Phone (770) 222-8900

209 Cooley Dr
Ste 101
Villa Rica, GA 30180
Phone (770) 456-0911

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, 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": "1610841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787270400000",
    "number": "1760071484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 COOLEY DR STE 100",
            "city": "VILLA RICA",
            "state": "GA",
            "postal_code": "301807057",
            "telephone_number": "770-456-0911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 E WEST CONNECTOR",
            "city": "AUSTELL",
            "state": "GA",
            "postal_code": "301061358",
            "telephone_number": "770-438-1680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LACAVERA",
        "first_name": "ANGELIQUE",
        "name_prefix": "Dr.",
        "credential": "DNP-FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-17",
        "last_updated": "2026-08-21",
        "certification_date": "2026-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "GA",
            "license": "RN257986",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "APRN-AP257986",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austell, GA

Sources for this page

Verify at the official NPI Registry.