Active NPI
Brady Owen Wheeler
- Family Nurse Practitioner
- Canton, GA
National Provider Identifier
1073499109
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- RN316976
- Practice address
- 2000 Village Professional Dr
Canton, GA 30114-8498 - Phone
- (678) 661-4545
- NPI assigned
- Aug 13, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | RN316976 | GA | Primary |
Addresses
Primary practice location
2000 Village Professional Dr
Canton, GA 30114-8498
Mailing address
2000 Village Professional Dr
Canton, GA 30114-8498
Phone (678) 661-4545
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20251015004225 | GA | Order and Referring Only - Family Practice | 4486141140 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1755043200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1767052800000",
"number": "1073499109",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2000 VILLAGE PROFESSIONAL DR",
"city": "CANTON",
"state": "GA",
"postal_code": "301148498",
"telephone_number": "678-661-4545"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2000 VILLAGE PROFESSIONAL DR",
"city": "CANTON",
"state": "GA",
"postal_code": "301148498",
"telephone_number": "678-661-4545"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHEELER",
"first_name": "BRADY",
"middle_name": "OWEN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-08-13",
"last_updated": "2025-12-30",
"certification_date": "2025-12-30",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "GA",
"license": "RN316976",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Canton, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.