Individual provider Active NPI

Joanna Wesley, NP

  • Family Nurse Practitioner
  • Crestview, FL
National Provider Identifier
1194188797
Registry record updated Aug 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11014991 Issued in FL
Practice address
304 Merlin CT
Crestview, FL 32539-6753
Phone
(850) 783-0279
Fax
(850) 826-9051
NPI assigned
Mar 31, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 22, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN226798 GA
Family Nurse Practitioner 363LF0000X APRN11014991 FL Primary

Addresses

Primary practice location

304 Merlin CT
Crestview, FL 32539-6753

Mailing address

304 Merlin CT
Crestview, FL 32539-6753
Phone (850) 783-0279

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20181106002987 GA Practitioner - Nurse Practitioner 2365739950 Reassigns benefits to 1 organization
I20220225001846 FL Practitioner - Nurse Practitioner 2365739950 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Transitions Healthcare LLCGroup PAC ID 5890166631, 18 clinicians

Practice addresses (Care Compare)

15500 Roosevelt Blvd
Suite 101
Clearwater, FL 33760-3430
Phone (727) 214-4622

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN226798GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Qofl Services LLC CurrentSince Sep 25, 2018 Accepting new patients

Locations

239 Arrowhead Blvd
Jonesboro, GA 30236
Phone (404) 312-0496

Organizations & group practices 3

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1459382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692662400000",
    "number": "1194188797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 MERLIN CT",
            "city": "CRESTVIEW",
            "state": "FL",
            "postal_code": "325396753",
            "telephone_number": "850-783-0279",
            "fax_number": "850-826-9051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 MERLIN CT",
            "city": "CRESTVIEW",
            "state": "FL",
            "postal_code": "325396753",
            "telephone_number": "850-783-0279",
            "fax_number": "850-826-9051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WESLEY",
        "first_name": "JOANNA",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-03-31",
        "last_updated": "2023-08-22",
        "certification_date": "2023-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN226798",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11014991",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crestview, FL

Sources for this page

Verify at the official NPI Registry.