Individual provider Active NPI

Danelle Phelps Wilson, M.D.

  • Pediatrics Physician
  • Alpharetta, GA
National Provider Identifier
1023061751
Registry record updated Aug 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
54365 Issued in GA
Practice address
3180 North Point Pkwy, Suite 410
Alpharetta, GA 30005
Phone
(770) 664-0088
Fax
(770) 664-8228
NPI assigned
May 17, 2006
Last updated
Aug 25, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 054365 GA
Pediatrics Physician 208000000X 54365 GA Primary

Addresses

Primary practice location

3180 North Point Pkwy, Suite 410
Alpharetta, GA 30005

Mailing address

3180 North Point Pkwy, Suite 410
Alpharetta, GA 30005
Phone (770) 664-0088

Other names 1

  • Danelle Phelps Other name

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
I20230314000217 GA Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 4880068949

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
054365GAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Point Pediatrics Pediatrics CurrentSince Aug 28, 2022 Accepting new patients
Northside Hospital, Inc. Past Accepting new patients

Locations

3180 North Point Pkwy
Ste 410
Alpharetta, GA 30005
Phone (770) 664-0088

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": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661385600000",
    "number": "1023061751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3180 NORTH POINT PKWY, SUITE 410",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "30005",
            "telephone_number": "770-664-0088",
            "fax_number": "770-664-8228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3180 NORTH POINT PKWY, SUITE 410",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "30005",
            "telephone_number": "770-664-0088",
            "fax_number": "770-664-8228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "DANELLE",
        "middle_name": "PHELPS",
        "name_prefix": "Mrs.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-17",
        "last_updated": "2022-08-25",
        "certification_date": "2022-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "054365",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "54365",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DANELLE",
            "last_name": "PHELPS",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Alpharetta, GA

Sources for this page

Verify at the official NPI Registry.