Individual provider Active NPI

Janna Levisha McWilson, FNP-C

  • Family Nurse Practitioner
  • Smyrna, GA
National Provider Identifier
1396573200
Registry record updated Oct 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN192660 Issued in GA
Practice address
3240 S Cobb Dr SE
Smyrna, GA 30080-4194
Phone
(678) 356-4212
NPI assigned
Jul 23, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 24, 2024

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 RN192660 GA Primary

Addresses

Primary practice location

3240 S Cobb Dr SE
Smyrna, GA 30080-4194

Mailing address

PO Box 932958
Cleveland, OH 44193-0028
Phone (678) 356-4212

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN192660GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
TLC of Georgia LLC Family CurrentSince Oct 17, 2024 Accepting new patients

Locations

455 Nathan Dean Blvd
Dallas, GA 30132
Phone (770) 443-8776

3240 S Cobb Dr SE
Smyrna, GA 30080
Phone (770) 433-3420

2620 Elm Hill Pike
Nashville, TN 37214
Phone (615) 425-4211

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1721692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729728000000",
    "number": "1396573200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 932958",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441930028",
            "telephone_number": "678-356-4212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3240 S COBB DR SE",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300804194",
            "telephone_number": "678-356-4212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCWILSON",
        "first_name": "JANNA",
        "middle_name": "LEVISHA",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-07-23",
        "last_updated": "2024-10-24",
        "certification_date": "2024-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN192660",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Smyrna, GA

Sources for this page

Verify at the official NPI Registry.