Individual provider Active NPI

Lauren Kathleen Culpepper

  • Women's Health Nurse Practitioner
  • Conyers, GA
National Provider Identifier
1760295331
Registry record updated Jan 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
RN283031 Issued in GA
Practice address
3240 Avalon Blvd
Conyers, GA 30013-6320
Phone
(770) 860-1133
NPI assigned
Jan 28, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X RN283031 GA Primary

Addresses

Primary practice location

3240 Avalon Blvd
Conyers, GA 30013-6320

Mailing address

3240 Avalon Blvd
Conyers, GA 30013-6320

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
I20250521000591 GA Practitioner - Nurse Practitioner 9638697824 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Greystone OBGYN PCGroup PAC ID 1153390497, 10 clinicians

Practice addresses (Care Compare)

3240 Avalon Blvd
Conyers, GA 30013-6320
Phone (770) 860-1133

4134 Hwy 278 NE
Covington, GA 30014-2494
Phone (770) 788-7447

4182 Hwy 278 NE
Covington, GA 30014-2494
Phone (770) 860-1133

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN283031GAMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Greystone OBGYN PC CurrentSince Feb 27, 2025 Accepting new patients

Locations

3240 Avalon Blvd
Conyers, GA 30013
Phone (770) 860-1133

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": "1738022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738022400000",
    "number": "1760295331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3240 AVALON BLVD",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300136320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3240 AVALON BLVD",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300136320",
            "telephone_number": "770-860-1133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CULPEPPER",
        "first_name": "LAUREN",
        "middle_name": "KATHLEEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-01-28",
        "last_updated": "2025-01-28",
        "certification_date": "2025-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "GA",
            "license": "RN283031",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conyers, GA

Sources for this page

Verify at the official NPI Registry.