Active NPI
Antoinette Wooten
- Nurse's Aide
- Grayson, GA
National Provider Identifier
1154095057
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse's Aide
- License
- CN0030054335
- Practice address
- 1233 Lakeview Cove Dr
Grayson, GA 30017-7916 - Phone
- (404) 775-8044
- Fax
- (404) 759-2550
- NPI assigned
- Aug 4, 2021
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Nurse's Aide | 376K00000X | CN0030054335 | GA | Primary |
Addresses
Primary practice location
1233 Lakeview Cove Dr
Grayson, GA 30017-7916
Mailing address
1233 Lakeview Cove Dr
Grayson, GA 30017-7916
Phone (404) 775-8044
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 |
|---|---|---|---|
| CN0030054335 | GA | MD | Nurse's Aide |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wooten Healthcare Services | Current | Accepting new patients |
Organizations & group practices 1
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.
-
- Nursing Care Agency
- Grayson, GA
- NPI 1225796758
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1628035200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1638316800000",
"number": "1154095057",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1233 LAKEVIEW COVE DR",
"city": "GRAYSON",
"state": "GA",
"postal_code": "300177916",
"telephone_number": "404-775-8044",
"fax_number": "404-759-2550"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1233 LAKEVIEW COVE DR",
"city": "GRAYSON",
"state": "GA",
"postal_code": "300177916",
"telephone_number": "404-775-8044",
"fax_number": "404-759-2550"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOOTEN",
"first_name": "ANTOINETTE",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-08-04",
"last_updated": "2021-12-01",
"certification_date": "2021-12-01",
"status": "A"
},
"taxonomies": [
{
"code": "376K00000X",
"taxonomy_group": "",
"desc": "Nurse's Aide",
"state": "GA",
"license": "CN0030054335",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grayson, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 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.