Active NPI
Juanita Norris, CPNP
- Pediatric Nurse Practitioner
- Toccoa, GA
National Provider Identifier
1285627372
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- 75091
- Practice address
- 58 Big a Road
Toccoa, GA 30577-6017 - Phone
- (706) 886-8419
- Fax
- (706) 886-4479
- NPI assigned
- Aug 24, 2005
- 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 |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | 75091 | GA | Primary |
Addresses
Primary practice location
58 Big a Road
Toccoa, GA 30577-6017
Mailing address
274 Big a Rd
Toccoa, GA 30577-6002
Phone (706) 886-8419
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000581677ABEF | Medicaid | GA |
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)
- Enrolled
- Credentials
- Certified Pediatric Nurse Practitioner, Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 75091 | GA | MD | Pediatric Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1124841600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1568937600000",
"number": "1285627372",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "274 BIG A RD",
"city": "TOCCOA",
"state": "GA",
"postal_code": "305776002",
"telephone_number": "706-886-8419",
"fax_number": "706-886-4479"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "58 BIG A ROAD",
"city": "TOCCOA",
"state": "GA",
"postal_code": "305776017",
"telephone_number": "706-886-8419",
"fax_number": "706-886-4479"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NORRIS",
"first_name": "JUANITA",
"credential": "CPNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-08-24",
"last_updated": "2019-09-20",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "GA",
"license": "75091",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000581677ABEF",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Toccoa, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.