Individual provider Active NPI

Cerita Willie

  • Specialist
  • Atlanta, GA
National Provider Identifier
1083098065
Registry record updated Jul 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Practice address
1755 The Exchange SE
Suite 330M
Atlanta, GA 30339-7400
Phone
(404) 216-2296
NPI assigned
Jul 20, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2015

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X Primary
Research Study Specialist 1744R1102X
Health Educator 174H00000X
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

1755 The Exchange SE
Suite 330M
Atlanta, GA 30339-7400

Mailing address

1865 Lyon Ave SW
Atlanta, GA 30331-8450
Phone (404) 216-2296

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1437350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437350400000",
    "number": "1083098065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1865 LYON AVE SW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303318450",
            "telephone_number": "404-216-2296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1755 THE EXCHANGE SE",
            "address_2": "SUITE 330M",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303397400",
            "telephone_number": "404-216-2296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIE",
        "first_name": "CERITA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-20",
        "last_updated": "2015-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1744R1102X",
            "taxonomy_group": "",
            "desc": "Specialist, Research Study",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "174H00000X",
            "taxonomy_group": "",
            "desc": "Health Educator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.