Individual provider Active NPI

Lida Rajaee, FNP

  • Family Nurse Practitioner
  • Cumming, GA
National Provider Identifier
1780349282
Registry record updated Mar 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN297207 Issued in GA
Practice address
5550 Bethelview Rd
Cumming, GA 30040-6859
Phone
(678) 456-4989
NPI assigned
Nov 1, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2025

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 RN297207 GA Primary

Addresses

Primary practice location

5550 Bethelview Rd
Cumming, GA 30040-6859

Mailing address

2620 Elm Hill Pike
Nashville, TN 37214-3108

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
I20211209001482 GA Practitioner - Nurse Practitioner 7416347265

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1275 Hwy 54 W
Suite 201
Fayetteville, GA 30214-4538

2620 Elm Hill Pike
Nashville, TN 37214-3108

378 Marketplace Pkwy
Dawsonville, GA 30534-7266

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
TLC of Georgia LLC Family CurrentSince Jul 17, 2022 Accepting new patients

Locations

5550 Bethelview Rd
Cumming, GA 30040
Phone (678) 456-4054

455 Nathan Dean Blvd
Dallas, GA 30132
Phone (770) 443-8776

378 Marketplace Pkwy
Dawsonville, GA 30534
Phone (470) 375-1995

3600 Dallas Hwy SW
Marietta, GA 30064
Phone (770) 420-9170

2620 Elm Hill Pike
Nashville, TN 37214
Phone (615) 425-4211

Interoperability endpoints

  • Direct secure messaging: lida.rajaee@krogerhealth.eclinicaldirectplus.com

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": "1635724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741996800000",
    "number": "1780349282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2620 ELM HILL PIKE",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372143108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5550 BETHELVIEW RD",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300406859",
            "telephone_number": "678-456-4989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAJAEE",
        "first_name": "LIDA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-01",
        "last_updated": "2025-03-15",
        "certification_date": "2025-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN297207",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cumming, GA

Sources for this page

Verify at the official NPI Registry.