Individual provider Active NPI

Janna Williams-Pitts, PHD

  • Psychologist
  • Kennesaw, GA
National Provider Identifier
1063895837
Registry record updated Oct 31, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY004158 Issued in GA
Practice address
3805 Cherokee St NW
Kennesaw, GA 30144-2085
Phone
(470) 956-3950
Fax
(770) 565-1830
NPI assigned
Jun 29, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 20042863A IN
Psychologist 103T00000X PSY004158 GA Primary

Addresses

Primary practice location

3805 Cherokee St NW
Kennesaw, GA 30144-2085

Mailing address

805 Sandy Plains Road
Medical Staff Services
Marietta, GA 30066-6340

Other practice location 1

1725 E Tipton St
Suite 200
Seymour, IN 47274-3561
Phone (812) 523-0386

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jwilliamspitts312285@directwellstar.org

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190325000698 GA Practitioner - Clinical Psychologist 8426346537 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Wellstar Medical Group LLCGroup PAC ID 6709065402, 3,059 clinicians

Practice addresses (Care Compare)

3805 Cherokee NWST
Kennesaw, GA 30144-2085
Phone (770) 426-5665

5150 Stilesboro N W Rd
Suite 220
Kennesaw, GA 30152-7742
Phone (770) 424-8222

Merit-based Incentive Payment System (MIPS)

Final score
93.93 of 100Reported as apm
Quality
82.14
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PSY004158GAMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Wellstar Medical Group, LLC Current Accepting new patients
Wellstar Medical Group, LLC CurrentSince Mar 1, 2019 Accepting new patients

Locations

5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222

3805 Cherokee St NW
Kennesaw, GA 30144
Phone (770) 426-5665

805 Sandy Plains Rd
Marietta, GA 30066
Phone (770) 792-1616

Interoperability endpoints

  • Direct secure messaging: jwilliamspitts312285@directwellstar.org

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": "1435536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572480000000",
    "number": "1063895837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 SANDY PLAINS ROAD",
            "address_2": "MEDICAL STAFF SERVICES",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300666340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3805 CHEROKEE ST NW",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301442085",
            "telephone_number": "470-956-3950",
            "fax_number": "770-565-1830"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1725 E Tipton St",
            "address_2": "Suite 200",
            "address_purpose": "LOCATION",
            "city": "Seymour",
            "state": "IN",
            "postal_code": "472743561",
            "country_code": "US",
            "telephone_number": "812-523-0386",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMS-PITTS",
        "first_name": "JANNA",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-29",
        "last_updated": "2019-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "IN",
            "license": "20042863A",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "GA",
            "license": "PSY004158",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jwilliamspitts312285@directwellstar.org",
            "affiliation": "N",
            "address_1": "3805 Cherokee St NW",
            "city": "Kennesaw",
            "state": "GA",
            "country_code": "US",
            "postal_code": "301442085",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kennesaw, GA

Sources for this page

Verify at the official NPI Registry.