Milan Johnson Wade, CPNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

RN234027 Issued in GA

Practice address

5959 Highway 53 E Ste 100
Dawsonville, GA 30534-6288

Phone

(706) 381-6125

Fax

(706) 531-0075

NPI assigned

Feb 28, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Pediatric Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: milan.johnson-wade.1@24108.direct.athenahealth.com

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.

• Northside Primary Care Professional Services,LLC

  • Family Medicine Physician
  • Atlanta, GA
  • NPI 1922397553
  Medicare reassignment NPD
• Northside Primary Care Professional Services, LLC

  • Urgent Care Clinic/Center
  • Dawsonville, GA
  • NPI 1215369715
  NPD
• Woodstock Pediatric Medicine

  • Pediatrics Physician
  • Woodstock, GA
  • NPI 1841402781
  NPD (past)

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

{
    "created_epoch": "1519776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674086400000",
    "number": "1174024780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 307",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300280307",
            "telephone_number": "770-887-1668",
            "fax_number": "770-781-9937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5959 HIGHWAY 53 E STE 100",
            "city": "DAWSONVILLE",
            "state": "GA",
            "postal_code": "305346288",
            "telephone_number": "706-381-6125",
            "fax_number": "706-531-0075"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2000 Professional Way # 200",
            "address_purpose": "LOCATION",
            "city": "Woodstock",
            "state": "GA",
            "postal_code": "301884093",
            "country_code": "US",
            "telephone_number": "770-517-8788",
            "fax_number": "770-517-0260",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON WADE",
        "first_name": "MILAN",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-28",
        "last_updated": "2023-01-19",
        "certification_date": "2023-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "GA",
            "license": "RN234027",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003202448A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rachel I Jacobs, MD
• Ashley Lashey James, PHARM.D.
• Courtney Jenkins, PT, DPT
• Jennifer Carson Dba Carson Counseling
• John P. Fox DDS, PC
• Douglas Wade Jones
• Kaylee Jones
• Shannon Jordan-Sutton
• Joyner Behavioral Health LLC
• Mercedes Kamerman, PSYD

• Pediatric Nurse Practitioner in Dawsonville, GA
• Providers in Dawsonville, GA by specialty
• Pediatric Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2023; 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.

Verify at the official NPI Registry.