Individual provider Active NPI

Molly Wilber, AGACNP

  • Nurse Practitioner
  • Atlanta, GA
National Provider Identifier
1316567860
Registry record updated Jun 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN269925 Issued in GA
Practice address
5730 Glenridge Dr Ste 200
Atlanta, GA 30328-5579
Phone
(404) 256-1844
NPI assigned
Apr 24, 2020
Last updated
Jun 1, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 1, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN269925 GA Primary
Registered Nurse 163W00000X RN269925 GA

Addresses

Primary practice location

5730 Glenridge Dr Ste 200
Atlanta, GA 30328-5579

Mailing address

1930 Brannan Rd
McDonough, GA 30253-4310
Phone (678) 284-4040

Other names 1

  • Molly O'Keeffe Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20211222000440 GA Practitioner - Nurse Practitioner 3476944711 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northside Radiology Associates LLCGroup PAC ID 4486555398, 381 clinicians

Practice addresses (Care Compare)

1000 Johnson Ferry Rd
Atlanta, GA 30342-1606
Phone (404) 662-2438

1000 Johnson Ferry Rd NE
Atlanta, GA 30342-1606
Phone (404) 662-2438

1400 Hembree Rd
Suite 150
Roswell, GA 30076-5711
Phone (404) 851-6577

300 Valley Brook Way NE
Atlanta, GA 30342-3377
Phone (404) 662-2438

314 Valley Brook Way NE
Atlanta, GA 30342-3377
Phone (404) 662-2438

50 Battle Ridge Dr
Atlanta, GA 30342-2451
Phone (404) 662-2438

845 Prince Ave
Athens, GA 30606-2723
Phone (404) 851-6577

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Northside Radiology Associates LLC CurrentSince Aug 24, 2024 Accepting new patients
Urological Professional Services, LLC CurrentSince Jul 18, 2022 Accepting new patients
Georgia Urology PA CurrentSince Jul 18, 2022 Accepting new patients
Georgia Urology, PA CurrentSince Jul 18, 2022 Accepting new patients

Locations

4450 Calibre Xing NW
Acworth, GA 30101
Phone (770) 607-1893

1930 Brannan Rd
McDonough, GA 30253
Phone (678) 284-4040

1000 Johnson Ferry Rd
Sandy Springs, GA 30342
Phone (404) 851-8737

5730 Glenridge Dr
Ste 200
Sandy Springs, GA 30328
Phone (404) 252-5206

900 Towne Lake Pkwy
Ste 200
Woodstock, GA 30189
Phone (678) 494-9201

Interoperability endpoints

  • Direct secure messaging: molly.wilber.p1@direct.gupa.nextgenshare.com

Organizations & group practices 4

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.

Hospital & facility affiliations 3

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": "1587686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654041600000",
    "number": "1316567860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1930 BRANNAN RD",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302534310",
            "telephone_number": "678-284-4040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5730 GLENRIDGE DR STE 200",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303285579",
            "telephone_number": "404-256-1844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILBER",
        "first_name": "MOLLY",
        "credential": "AGACNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-24",
        "last_updated": "2022-06-01",
        "certification_date": "2022-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN269925",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GA",
            "license": "RN269925",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MOLLY",
            "last_name": "O'KEEFFE",
            "credential": "AGACNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.