Lacy Autumn Moran, NP

Primary specialty

Emergency Registered NurseTaxonomy code 163WE0003X

License

RN251152 Issued in GA

Practice address

1035 Red Bud Rd NE
Calhoun, GA 30701-6010

Phone

(706) 602-7800

NPI assigned

Nov 5, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Lacy Autumn Long Former name

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

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.

• Gordon Emergency Physicians, LLC

  • Emergency Medicine Physician
  • Calhoun, GA
  • NPI 1205290467
  Medicare reassignment NPD
• Murray Emergency Physicians, LLC

  • Emergency Medicine Physician
  • Chatsworth, GA
  • NPI 1043783970
  Medicare reassignment NPD
• Gordon Emergency Physicians, LLC

  • Emergency Medicine Physician
  • Chatsworth, GA
  • NPI 1639621485
  NPD

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

{
    "created_epoch": "1730764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730764800000",
    "number": "1902629389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1035 RED BUD RD NE",
            "city": "CALHOUN",
            "state": "GA",
            "postal_code": "307016010",
            "telephone_number": "706-602-7800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1035 RED BUD RD NE",
            "city": "CALHOUN",
            "state": "GA",
            "postal_code": "307016010",
            "telephone_number": "706-602-7800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORAN",
        "first_name": "LACY",
        "middle_name": "AUTUMN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-05",
        "last_updated": "2024-11-05",
        "certification_date": "2024-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WE0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Emergency",
            "state": "GA",
            "license": "RN251152",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LACY",
            "last_name": "LONG",
            "middle_name": "AUTUMN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Mayur D Mody, M.D.
• Monyei Holdings Inc (FHS Pharmacy)
• Nikitia Yvette Moore-Floyd
• Crystal Wade Moore, FNP-C
• Katie Moraitakis, LCSW
• Sandra Gail Morgan, CCC-SLP
• Tyler Morris, DC
• Stephani Morss, APC
• Julie T Motes, RPH
• Laura Scileppi Mudrich, NP

• Emergency Registered Nurse in Calhoun, GA
• Providers in Calhoun, GA by specialty
• Emergency Registered Nurse in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.