Individual provider Active NPI

Qwenita Wiggins

  • Private Vehicle
  • Atlanta, GA
National Provider Identifier
1205600020
Registry record updated Nov 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Private VehicleTaxonomy code 347C00000X
License
055217650 Issued in GA
Practice address
2051 Flat Shoals Rd SE Apt C5
Atlanta, GA 30316-3033
Phone
(404) 416-0057
NPI assigned
Nov 13, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Private Vehicle 347C00000X 055217650 GA Primary

Addresses

Primary practice location

2051 Flat Shoals Rd SE Apt C5
Atlanta, GA 30316-3033

Mailing address

2051 Flat Shoals Rd SE Apt C5
Atlanta, GA 30316-3033
Phone (404) 416-0057

Other practice location 1

3069 Amwiler Rd Ste 1
Atlanta, GA 30360-2825
Phone (770) 686-7996

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

LicenseStateTypeSpecialty
055217650GAMDPrivate Vehicle

NPI Registry JSON

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

{
    "created_epoch": "1699833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699833600000",
    "number": "1205600020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2051 FLAT SHOALS RD SE APT C5",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303163033",
            "telephone_number": "404-416-0057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2051 FLAT SHOALS RD SE APT C5",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303163033",
            "telephone_number": "404-416-0057"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3069 Amwiler Rd Ste 1",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303602825",
            "country_code": "US",
            "telephone_number": "770-686-7996",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WIGGINS",
        "first_name": "QWENITA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-11-13",
        "last_updated": "2023-11-13",
        "certification_date": "2023-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "347C00000X",
            "taxonomy_group": "",
            "desc": "Private Vehicle",
            "state": "GA",
            "license": "055217650",
            "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 Nov 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.