Wildwine Belizaire, FNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

RN315873 Issued in GA

Practice address

7560 Butner Rd
Fairburn, GA 30213-1914

Phone

(800) 266-8874

Fax

(877) 366-4776

NPI assigned

May 15, 2023

Last updated

Jul 18, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

QSM-Ga, IncGroup PAC ID 3779842729, 12 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• QSM-Ga, Inc

  • Surgery Physician
  • Atlanta, GA
  • NPI 1356852123
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1684108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784332800000",
    "number": "1356032056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3800 S OCEAN DR STE 209",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330192915",
            "telephone_number": "800-226-8874",
            "fax_number": "877-366-4776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7560 BUTNER RD",
            "city": "FAIRBURN",
            "state": "GA",
            "postal_code": "302131914",
            "telephone_number": "800-266-8874",
            "fax_number": "877-366-4776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BELIZAIRE",
        "first_name": "WILDWINE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-15",
        "last_updated": "2026-07-18",
        "certification_date": "2026-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN315873",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathanette Barnes, PH.D.
• Nicole Bartell, LPC
• William Lawrence Bassett, PT, DPT
• Lashawnda Beasley, RDN, LD, CLC
• Beat the Odds Agency Incorporated (Beat the Odds Agency)
• Bella Gardens Senior Living
• Monique D Besong, PHARMD
• Tusonah Ann Birmingham, RPSGT
• Grace M Blackwood, LPC
• Blaylock Rehabilitation, LLC

• Nurse Practitioner in Fairburn, GA
• Providers in Fairburn, GA by specialty
• Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.