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Lori Angeleene Modly , CPNP

Nurse Practitioner - Pediatrics • Gainesville, GA

Active NPI 1871860692 Individual Practitioner Female Practitioner
Practice location in NPPES

743 Spring St Ne
Gainesville, GA 305013715

Call 7705353611 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

743 Spring St Ne

Gainesville, GA 305013715

Telephone 7705353611
Fax 7705357092
Organization at the Same NPPES Address or Phone
Northeast Georgia Medical Center, Inc. Facility NPI 1427055821

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

Industry payments (Open Payments)

No Open Payments records are listed for this clinician for 2021–2025.

Guide: How to read an Open Payments record

NPI first issued

2011

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, “Does your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Compared with the same specialty in Gainesville and Georgia

15 active clinicians are listed under Nurse Practitioner - Pediatrics with a practice address in Gainesville, GA (919 in Georgia).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Gainesville

0% of these 15 clinicians have the CMS telehealth indicator.

0% of these 15 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo · Report an error.

Specialties & License Numbers Reported to NPPES

Nurse Practitioner - Pediatrics Primary Specialty

NUCC Taxonomy Code: 363LP0200X

License # reported to NPPES GA RN201247
Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Georgia Composite Medical Board.
Look Up on State Board Site

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid ID
003116595A (GA)
Other Identifier Amerigroup
01467542 (GA)
Other Identifier Wellcare
643406 (GA)

Clinicians Sharing This Practice Address or Phone

Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.

6 listed
Candice Evans , CFNP

Nurse Practitioner - Pediatrics

NPI 1215909213
NPI 1083605554

Doctor of Medicine (M.D.)

NPI 1053391979

Doctor of Medicine (M.D.)

NPI 1366603326

Doctor of Medicine (M.D.)

NPI 1396372496

Doctor of Osteopathic Medicine (D.O.)

Haley Wilson , PA-C

Physician Assistant - Medical

NPI 1336111046

Physician Assistant (Certified)

Career & Practice History

NPI enumerated November 22, 2011.

No changes to the name, practice address, taxonomy or NPI status in this record have been observed in the monthly NPPES data files from January 2017 to August 2026.

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NPI Administrative Meta

NPI Number: 1871860692
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: November 22, 2011
Last Update: February 28, 2012
Sole Proprietor: No

Mailing Address

Po Box 658

Gainesville, GA 305030658

Phone: 7707181122

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.