Amisa Jiwani, APRN

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

RN312490 Issued in GA

Practice address

4905 Courtney Dr
Forest Park, GA 30297-1427

Phone

(404) 366-3636

Fax

(404) 362-0808

NPI assigned

Apr 9, 2025

Last updated

Apr 9, 2025By 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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Daffodil Pediatrics and Family Medicine

  • Pediatrics Physician
  • Forest Park, GA
  • NPI 1851663124
  NPD (past)

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

{
    "created_epoch": "1744156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744156800000",
    "number": "1407641764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4905 COURTNEY DR",
            "city": "FOREST PARK",
            "state": "GA",
            "postal_code": "302971427",
            "telephone_number": "404-366-3636",
            "fax_number": "404-362-0808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4905 COURTNEY DR",
            "city": "FOREST PARK",
            "state": "GA",
            "postal_code": "302971427",
            "telephone_number": "404-366-3636",
            "fax_number": "404-362-0808"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4166 Buford Hwy NE Ste 11021103",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303451081",
            "country_code": "US",
            "telephone_number": "404-366-3636",
            "fax_number": "404-362-0808",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JIWANI",
        "first_name": "AMISA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-09",
        "last_updated": "2025-04-09",
        "certification_date": "2025-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "GA",
            "license": "RN312490",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Niambi Ibim, OTR/L
• Integrated Health and Wellness Solutions
• Ips of Forest Park LLC
• Rose M James, DPM
• Charles Jenkins III, APRN
• Xavier Johnson, NCTMB, CMT, CMMT
• Michael Reu Johnston, D.C.
• Nadrieka Jones, APRN
• Vaughnette M Jones, MD
• Abigail Kamishlian, M.D.

• Pediatric Nurse Practitioner in Forest Park, GA
• Providers in Forest Park, GA by specialty
• Pediatric Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 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.