Individual provider Active NPI

Kelly Nicole Vanwert, FNP-C

  • Family Nurse Practitioner
  • Atlanta, GA
National Provider Identifier
1306638028
Registry record updated May 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F02250231 Issued in GA
Practice address
3390 Stratford Rd NE Unit 904
Atlanta, GA 30326-1741
Phone
(720) 883-2158
NPI assigned
May 19, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 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 F02250231 GA Primary

Addresses

Primary practice location

3390 Stratford Rd NE Unit 904
Atlanta, GA 30326-1741

Mailing address

3390 Stratford Rd NE Unit 904
Atlanta, GA 30326-1741
Phone (720) 883-2158

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
F02250231GAMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1747612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747612800000",
    "number": "1306638028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3390 STRATFORD RD NE UNIT 904",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303261741",
            "telephone_number": "720-883-2158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3390 STRATFORD RD NE UNIT 904",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303261741",
            "telephone_number": "720-883-2158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANWERT",
        "first_name": "KELLY",
        "middle_name": "NICOLE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-05-19",
        "last_updated": "2025-05-19",
        "certification_date": "2025-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "F02250231",
            "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 May 19, 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.