NATHAN SCOTT LYCAN (NPI# 1366755993) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366755993 |
| Entity Type | Individual |
| Full Name | NATHAN SCOTT LYCAN |
| Credential | PA |
| Practice Address |
1968 Peachtree Road Nw Atlanta GA 30309 |
| Mailing Address |
275 Collier Rd Nw Suite 500 Atlanta GA 30309-1709 |
| Practice Telephone | 4046052800 |
| Practice Fax Number | 4043515983 |
| Mailing Telephone | 4046052800 |
| Mailing Fax Number | 4043515983 |
| Enumeration Date | 2010-07-25 |
| Last Update Date | 2012-05-15 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
005811 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | GA LICENSE | 005811 | 01 |
| Street Address |
1968 PEACHTREE ROAD NW |
| City | ATLANTA |
| State | GA |
| Zip Code | 30309 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366449498 | James F Beatty | Specialist | 1968 Peachtree Road Nw, B336, Atlanta, GA 30309-1281 | 2005-07-05 |
| 1861041972 | Mallory Catall | Physician Assistant | 1968 Peachtree Road Nw, Atlanta, GA 30309-1796 | 2019-09-11 |
| 1598283137 | Morgan Lee Kim | Anesthesiologist Assistant | 1968 Peachtree Road Nw, Atlanta, GA 30309 | 2017-09-04 |
| 1629300181 | Heather Diane Boehm Maginn | Physician Assistant | 1968 Peachtree Road Nw, Atlanta, GA 30309-1281 | 2010-02-09 |
| 1528390135 | Phillip V Oliver | Registered Nurse | 1968 Peachtree Road Nw, Atlanta, GA 30309-1281 | 2010-02-06 |
| 1366772907 | Harrison C Ojimma | Registered Nurse | 1968 Peachtree Road Nw, Atlanta, GA 30309-1281 | 2010-01-04 |
| 1720217805 | Haley C Gordon | Registered Nurse | 1968 Peachtree Road Nw, Atlanta, GA 30309-1281 | 2009-07-09 |
| 1033348727 | Molly A Peek | Nurse Anesthetist, Certified Registered | 1968 Peachtree Road Nw, Atlanta, GA 30309-1281 | 2009-07-02 |
| 1346475746 | Bertha O Onyemaobi | Registered Nurse | 1968 Peachtree Road Nw, Atlanta, GA 30309-1281 | 2009-05-28 |
| 1710121140 | Adaeze C Adigweme | Internal Medicine | 1968 Peachtree Road Nw, Kaiser Permanente At Piedmont Hospital, Atlanta, GA 30309 | 2009-04-29 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396382354 | Astoria Dentistry LLC | Dentist | 2233 Peachtree Rd. Nw, Suite 300, Atlanta, GA 30309 | 2019-12-09 |
| 1487133740 | S2 Telehealth Technologies, LLC | Psychiatry & Neurology | 915 W Peachtree St Nw Apt 522, Atlanta, GA 30309 | 2018-08-08 |
| 1841782620 | Janie Mardis | Social Worker | 3 Park Ln Ne, Apt H, Atlanta, GA 30309 | 2018-06-06 |
| 1083102842 | Veronica L Bentley | Specialist/Technologist, Other | 1170 Peachtree Street Suite 1200, Atlanta, GA 30309 | 2018-04-27 |
| 1427566363 | Net Medical Corp | Chiropractor | 1100 Spring St Sw, Ste#700, Atlanta, GA 30309 | 2018-01-12 |
| 1871000463 | Mary James (jamie) Johnson | Counselor | 1100 Spring Street, Suite 380, Atlanta, GA 30309 | 2018-01-04 |
| 1306377817 | Aliyah Lamis Scott | Social Worker | 1745 Peachtree Road Ne, Kaiser Permanente Brookwood Medical Office, Atlanta, GA 30309 | 2017-03-26 |
| 1013450774 | Caroline Hallen | Nurse Practitioner | 105 Collier Rd Nw Suite 3040, Atlanta, GA 30309 | 2016-11-29 |
| 1528501723 | Ant-aging Queen | Nutritionist | 1801 Atlanta Medical Clinic, Suite 250, Atlanta, GA 30309 | 2016-11-21 |
| 1790231439 | Nurse 2 Health Home Care LLC | Home Health | 1075 Peachtree Street Ne, Atlanta, GA 30309 | 2016-09-01 |
| Find all providers in zip 30309 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245838374 | Erica Elizabeth West | Physician Assistant | 1155 Mount Vernon Hwy Ste 101, Atlanta, GA 30338-5439 | 2020-10-12 |
| 1841851680 | Lauren Price Fogarty | Physician Assistant | 5445 Meridian Marks Rd Ste 430, Atlanta, GA 30342-4755 | 2019-06-24 |
| 1417422916 | Alison Miller | Physician Assistant | 993d Johnson Fy Rd Ne, Atlanta, GA 30342-1602 | 2018-10-10 |
| 1588139414 | Tammy May Luu | Physician Assistant | 1150 Hammond Dr Ste 310, Atlanta, GA 30328-7500 | 2018-10-08 |
| 1104323476 | Cody Weldon Howell | Physician Assistant | 303 Parkway Dr Ne # 404, Atlanta, GA 30312-1212 | 2018-04-12 |
| 1659895373 | Sudhisha Kumari Jala | Physician Assistant | 980 Johnson Ferry Rd Ste 820, Atlanta, GA 30342-1608 | 2017-08-03 |
| 1487178893 | Magdalena Kertscher | Physician Assistant | 105 Collier Rd Nw Ste 2010, Atlanta, GA 30309-1734 | 2017-07-27 |
| 1841738044 | Adrienne Anderson | Physician Assistant | 1800 Howell Mill Rd Nw Ste 450, Atlanta, GA 30318-2508 | 2017-02-08 |
| 1730623802 | Catherine Lynn Johnson | Physician Assistant | 1365 Clifton Rd Ne # C, Atlanta, GA 30322-1013 | 2016-12-08 |
| 1649626938 | Alex Phillip Schultz | Physician Assistant | 476 Wilmer St Ne, Unit 1230, Atlanta, GA 30308-2933 | 2016-05-05 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.