Active NPI
Vanessa Trotter-Wilson
- Behavior Technician
- Atlanta, GA
National Provider Identifier
1093396046
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- 19-107419
- Practice address
- 3340 Peachtree Rd NE Ste 1800
Atlanta, GA 30326-1064 - Phone
- (404) 487-6005
- NPI assigned
- Apr 20, 2021
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | 19-107419 | GA | Primary |
Addresses
Primary practice location
3340 Peachtree Rd NE Ste 1800
Atlanta, GA 30326-1064
Mailing address
280 Northern Ave Apt 27E
Avondale Estates, GA 30002-1253
Phone (678) 365-5750
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 |
|---|---|---|---|
| 19-107419 | GA | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1618876800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1618876800000",
"number": "1093396046",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "280 NORTHERN AVE APT 27E",
"city": "AVONDALE ESTATES",
"state": "GA",
"postal_code": "300021253",
"telephone_number": "678-365-5750"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3340 PEACHTREE RD NE STE 1800",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303261064",
"telephone_number": "404-487-6005"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TROTTER-WILSON",
"first_name": "VANESSA",
"name_prefix": "Mrs.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-04-20",
"last_updated": "2021-04-20",
"certification_date": "2021-03-24",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "GA",
"license": "19-107419",
"primary": true
}
],
"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 Apr 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.