Individual provider Active NPI

Lillie Washington, FNP-C

  • Family Nurse Practitioner
  • Peachtree Corners, GA
National Provider Identifier
1831942002
Registry record updated Feb 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN334094 Issued in GA
Practice address
3780 Holcomb Bridge Rd Ste D
Peachtree Corners, GA 30092-4877
Phone
(470) 275-3626
NPI assigned
Apr 8, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 906611 MS
Family Nurse Practitioner 363LF0000X 3-001664 AL
Family Nurse Practitioner 363LF0000X GAA-NP001904 GA
Family Nurse Practitioner 363LF0000X RN334094 GA Primary

Addresses

Primary practice location

3780 Holcomb Bridge Rd Ste D
Peachtree Corners, GA 30092-4877

Mailing address

3780 Holcomb Bridge Rd Ste D
Peachtree Corners, GA 30092-4877
Phone (470) 275-3626

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
I20250515001300 GA Practitioner - Nurse Practitioner 4284152067 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Vanderbilt University School of Medicine, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Solutions Pain and Interventional Spine DoctorsGroup PAC ID 6103204805, 3 clinicians

Practice addresses (Care Compare)

3780 Holcomb Bridge Rd
Suite D
Peachtree Corners, GA 30092-4877
Phone (470) 641-6444

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3-001664ALMDFamily Nurse Practitioner
GAA-NP001904GAMDFamily Nurse Practitioner
RN334094GAMDFamily Nurse Practitioner
906611MSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Solutions Pain and Interventional Spine Doctors CurrentSince Feb 15, 2025 Accepting new patients
Vitalx Wellness, LLC PastSince Apr 1, 2024 Accepting new patients
Atlanta Wellness Management Center, LLC Past Accepting new patients

Locations

4296 Memorial Dr
Ste C
Decatur, GA 30032
Phone (513) 297-8318

3780 Holcomb Bridge Rd
Ste D
Peachtree Corners, GA 30092
Phone (470) 275-3626

Organizations & group practices 3

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": "1712534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738800000000",
    "number": "1831942002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3780 HOLCOMB BRIDGE RD STE D",
            "city": "PEACHTREE CORNERS",
            "state": "GA",
            "postal_code": "300924877",
            "telephone_number": "470-275-3626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3780 HOLCOMB BRIDGE RD STE D",
            "city": "PEACHTREE CORNERS",
            "state": "GA",
            "postal_code": "300924877",
            "telephone_number": "470-275-3626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WASHINGTON",
        "first_name": "LILLIE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-08",
        "last_updated": "2025-02-06",
        "certification_date": "2025-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "906611",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "3-001664",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "GAA-NP001904",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN334094",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peachtree Corners, GA

Sources for this page

Verify at the official NPI Registry.