Individual provider Active NPI

Laqueta Nelson, FNP

  • Family Medicine Physician
  • Cumming, GA
National Provider Identifier
1982247433
Registry record updated Nov 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
RN145567 Issued in GA
Practice address
3970 Deputy Bill Cantrell Memorial Rd
Cumming, GA 30040
Phone
(678) 513-2273
NPI assigned
Oct 28, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 29, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X RN145567 GA Primary

Addresses

Primary practice location

3970 Deputy Bill Cantrell Memorial Rd
Cumming, GA 30040

Mailing address

2400 Herodian Way SE Ste 220
Smyrna, GA 30080-8500
Phone (770) 383-1415

Other practice location 1

232 Woodcreek Way
Acworth, GA 30101-2013
Phone (678) 793-4588

Other identifiers 1

IdentifierTypeStateIssuer
RN145567OtherGAFNP LICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Lnelson.fnp@ruinteractive.com Direct

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
I20200116003023 GA Practitioner - Nurse Practitioner 2961837000 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2400 Herodian Way SE
Suite 220
Smyrna, GA 30080-8500
Phone (770) 383-1415

Merit-based Incentive Payment System (MIPS)

Final score
89.65 of 100Reported as group
Quality
90.12
Promoting interoperability
100
Improvement activities
40
Cost
75.39

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Goodlife Cardiac Care, LLC CurrentSince Jan 2, 2023 Accepting new patients
Anemonefish Inpatient Services LLC CurrentSince Aug 1, 2021 Accepting new patients

Locations

960 Joe Frank Harris Pkwy SE
Cartersville, GA 30120
Phone (404) 554-2196

5126 Hospital Dr NE
Covington, GA 30014
Phone (770) 385-4340

2400 Herodian Way SE
Ste 220
Smyrna, GA 30080
Phone (678) 346-0808

Interoperability endpoints

  • Direct secure messaging: lnelson.fnp@ruinteractive.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1572220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669680000000",
    "number": "1982247433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 HERODIAN WAY SE STE 220",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300808500",
            "telephone_number": "770-383-1415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3970 DEPUTY BILL CANTRELL MEMORIAL RD",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "30040",
            "telephone_number": "678-513-2273"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "232 Woodcreek Way",
            "address_purpose": "LOCATION",
            "city": "Acworth",
            "state": "GA",
            "postal_code": "301012013",
            "country_code": "US",
            "telephone_number": "678-793-4588",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NELSON",
        "first_name": "LAQUETA",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-28",
        "last_updated": "2022-11-29",
        "certification_date": "2022-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "RN145567",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FNP LICENSE",
            "identifier": "RN145567",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Lnelson.fnp@ruinteractive.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "232 Woodcreek Way",
            "city": "Acworth",
            "state": "GA",
            "country_code": "US",
            "postal_code": "301012013",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Cumming, GA

Sources for this page

Verify at the official NPI Registry.