Aubry Lynn Knight, MSN, FNP-C
Individual provider Active NPI Family Nurse Practitioner · La Fayette, GA
NPI 1780152421 · NPPES record last updated Jul 31, 2019
Key facts
- NPI
- 1780152421
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 207148 (GA)
- Practice address
- 611 E Villanow St
La Fayette, GA 30728-2618 - Phone
- (706) 638-1606
- NPI assigned
- Nov 12, 2018
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Back to Life Medical Group, LLC
Practice addresses (Care Compare)
557 Riverstone Pkwy
Suite 140
Canton, GA 30114-5223
Phone (770) 345-4520
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in GA, TN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20181214002850 | GA | Practitioner - Nurse Practitioner | 8224373592 | Reassigns benefits to 2 organizations |
| I20190212002827 | TN | Practitioner - Nurse Practitioner | 8224373592 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Science - Nursing
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 207148 | GA | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Back to Life Medical Group, LLC | Family Medicine | Current |
Accepting new patients |
Locations
557 Riverstone Pkwy
Canton, GA 30114
Phone (770) 345-4520
557 Riverstone Pkwy
Ste 140
Canton, GA 30114
Phone (678) 552-6294
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 207148 | GA | Yes |
Addresses
Primary practice location
611 E Villanow St
La Fayette, GA 30728-2618
Mailing address
1949 Gunbarrel Rd Ste 206
Chattanooga, TN 37421-3188
Phone (423) 495-4345
Other providers in La Fayette, GA
- Christine Jo Jennings
- William Andrews Kemp Jr.
- Kaylea Kerr
- Emily King
- Michael L. Kisner
- Virginia Baldwin Kohl
- La Fayette Prescription Shop
- Lafayette After Hours, LLC
- Lafayette Family Care, LLC
- Lafayette Family Practice
All providers in La Fayette, GA · Family Nurse Practitioner in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 31, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.