Individual provider Active NPI

Sidney Krupa, FNP-C

  • Family Nurse Practitioner
  • Newnan, GA
National Provider Identifier
1255173407
Registry record updated Feb 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN300116 Issued in GA
Practice address
1825 Highway 34 E Ste 3400
Newnan, GA 30265-6433
Phone
(770) 400-9588
Fax
(470) 400-3452
NPI assigned
Jun 10, 2024
Last updated
Feb 26, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN300116 GA Primary

Addresses

Primary practice location

1825 Highway 34 E Ste 3400
Newnan, GA 30265-6433

Mailing address

20 S Robin LN
Newnan, GA 30263-6002
Phone (678) 416-0652

Other identifiers 1

IdentifierTypeStateIssuer
1255173407MedicaidGA

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
RN300116GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Healing on Wheels LLC CurrentSince Jun 16, 2024 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: sidney.krupa.1@20810.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1717977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740528000000",
    "number": "1255173407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 S ROBIN LN",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302636002",
            "telephone_number": "678-416-0652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1825 HIGHWAY 34 E STE 3400",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302656433",
            "telephone_number": "770-400-9588",
            "fax_number": "470-400-3452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRUPA",
        "first_name": "SIDNEY",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-10",
        "last_updated": "2025-02-26",
        "certification_date": "2025-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN300116",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1255173407",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newnan, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2025; 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.