Individual provider Active NPI

Lauren Erin Holcomb, PA-C

  • Surgical Physician Assistant
  • Atlanta, GA
National Provider Identifier
1790269579
Registry record updated Jun 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
8999 Issued in GA
Practice address
5667 Peachtree Dunwoody Rd Ste 310
Atlanta, GA 30342-1725
Phone
(404) 902-2485
Fax
(404) 857-3696
NPI assigned
Sep 18, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Surgical Physician Assistant 363AS0400X 8999 GA Primary

Addresses

Primary practice location

5667 Peachtree Dunwoody Rd Ste 310
Atlanta, GA 30342-1725

Mailing address

3460 Rose Arbor CT
Atlanta, GA 30340-4040
Phone (708) 752-5713

Other identifiers 1

IdentifierTypeStateIssuer
8999OtherGAGEORGIA COMPOSITE MEDICAL BOARD

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
I20181108000229 GA Practitioner - Physician Assistant 1355695461 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Mercer University School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northside Surgical Professional Services LLCGroup PAC ID 8628253424, 367 clinicians

Practice addresses (Care Compare)

1000 Johnson Ferry NE
Atlanta, GA 30342-1606

1000 Johnson Ferry Rd NE
Atlanta, GA 30342-1606
Phone (404) 851-8000

5445 Meridian Mark Rd
Atlanta, GA 30342-4755

5667 Peachtree Dunwoody Rd
Suite 310
Atlanta, GA 30342-1725
Phone (404) 902-2485

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8999GAMDSurgical Physician Assistant

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 and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1537228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749945600000",
    "number": "1790269579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3460 ROSE ARBOR CT",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303404040",
            "telephone_number": "708-752-5713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5667 PEACHTREE DUNWOODY RD STE 310",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421725",
            "telephone_number": "404-902-2485",
            "fax_number": "404-857-3696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLCOMB",
        "first_name": "LAUREN",
        "middle_name": "ERIN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-18",
        "last_updated": "2025-06-15",
        "certification_date": "2025-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "GA",
            "license": "8999",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GEORGIA COMPOSITE MEDICAL BOARD",
            "identifier": "8999",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.