Individual provider Active NPI

Morgan Brooke Lewallen, MSN, FNP-C

  • Family Nurse Practitioner
  • Decatur, GA
National Provider Identifier
1922608678
Registry record updated Mar 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN268593 Issued in GA
Practice address
402 W Ponce de Leon Ave
Decatur, GA 30030-2443
Phone
(404) 537-2521
NPI assigned
Oct 30, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN268593 GA
Family Nurse Practitioner 363LF0000X RN268593 GA Primary

Addresses

Primary practice location

402 W Ponce de Leon Ave
Decatur, GA 30030-2443

Mailing address

315 W Ponce de Leon Ave Ste 110
Decatur, GA 30030-2441
Phone (404) 312-8163

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221208002385 GA Practitioner - Family PracticePractitioner - Preventive Medicine 0446629778 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Preventive Medicine
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ponce Preventive Care LLCGroup PAC ID 6406987544, 10 clinicians

Practice addresses (Care Compare)

315 W Ponce de Leon Ave
Suite 110
Decatur, GA 30030-2441
Phone (404) 537-2521

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Master of Science - Nursing

Practice roles

OrganizationSpecialtyStatusNew patients
Ponce Preventive Care LLC CurrentSince Nov 22, 2022 Accepting new patients
Whole Family Medicine, LLC CurrentSince Nov 1, 2020 Accepting new patients

Locations

315 W Ponce de Leon Ave
Ste 110
Decatur, GA 30030
Phone (404) 371-9673

402 W Ponce de Leon Ave
Decatur, GA 30030
Phone (404) 377-9010

Interoperability endpoints

  • Direct secure messaging: morgan.littleton.1@9773.direct.athenahealth.com
  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1604016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678233600000",
    "number": "1922608678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 W PONCE DE LEON AVE STE 110",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300302441",
            "telephone_number": "404-312-8163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 W PONCE DE LEON AVE",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300302443",
            "telephone_number": "404-537-2521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWALLEN",
        "first_name": "MORGAN",
        "middle_name": "BROOKE",
        "credential": "MSN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-30",
        "last_updated": "2023-03-08",
        "certification_date": "2023-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GA",
            "license": "RN268593",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN268593",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, GA

Sources for this page

Verify at the official NPI Registry.