Active NPI
Frank Tichorla Wajule
- Psychiatric/Mental Health Nurse Practitioner
- Athens, GA
National Provider Identifier
1093361719
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- RN276761
- Practice address
- 240 Mitchell Bridge Rd
Athens, GA 30606-2043 - Phone
- (888) 839-0743
- NPI assigned
- Aug 18, 2019
- Last updated
- Aug 8, 2024
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | RN276761 | GA | Primary |
| Registered Nurse | 163W00000X | RN276761 | GA |
Addresses
Primary practice location
240 Mitchell Bridge Rd
Athens, GA 30606-2043
Mailing address
3913 Potomac Walk CT
Loganville, GA 30052-7635
Phone (678) 670-4407
Other practice location 1
175 Gwinnett Dr
Lawrenceville, GA 30046-8444
Phone (678) 209-2394
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN276761 | GA | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1566086400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1723075200000",
"number": "1093361719",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3913 POTOMAC WALK CT",
"city": "LOGANVILLE",
"state": "GA",
"postal_code": "300527635",
"telephone_number": "678-670-4407"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "240 MITCHELL BRIDGE RD",
"city": "ATHENS",
"state": "GA",
"postal_code": "306062043",
"telephone_number": "888-839-0743"
}
],
"practiceLocations": [
{
"address_1": "175 Gwinnett Dr",
"address_purpose": "LOCATION",
"city": "Lawrenceville",
"state": "GA",
"postal_code": "300468444",
"country_code": "US",
"telephone_number": "678-209-2394",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WAJULE",
"first_name": "FRANK",
"middle_name": "TICHORLA",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-08-18",
"last_updated": "2024-08-08",
"certification_date": "2024-08-08",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "GA",
"license": "RN276761",
"primary": true
},
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "GA",
"license": "RN276761",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Athens, GA
- Zane K Wade, MD
- Circe Wadley, RN
- Kim Wages, RN
- Brier Wagoner-McCann, LMSW
- Diane Larlee Wahlers, M.S.W.
- Wal-Mart Stores East LP (Walmart Pharmacy 10-5267)
- Wal-Mart Stores East LP (Wal-Mart Pharmacy 10-2811)
- Wal-Mart Stores East LP (Wal-Mart Pharmacy 10-1400)
- Wal-Mart Stores East, LP (Vision Center 30-1400)
- Wal-Mart Stores East, LP (Vision Center 30-2811)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.