Individual provider Active NPI

Diane L Wirth, ANP-BC

  • Adult Health Nurse Practitioner
  • Atlanta, GA
National Provider Identifier
1407969058
Registry record updated Jul 18, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
RN108564 NP Issued in GA
Practice address
1525 Clifton Rd NE
Suite 207
Atlanta, GA 30322-4200
Phone
(404) 778-4451
Fax
(404) 778-4355
NPI assigned
Aug 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X RN108564 NP GA Primary

Addresses

Primary practice location

1525 Clifton Rd NE
Suite 207
Atlanta, GA 30322-4200

Mailing address

1306 Janmar Rd
Snellville, GA 30078-2103
Phone (770) 979-1154

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
I20040120000489 GA Practitioner - Nurse Practitioner 7214838408 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
96.48 of 100Reported as group
Quality
87.56
Promoting interoperability
100
Improvement activities
40
Cost
75.14

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN108564 NPGAMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Grady Memorial Hospital Corporation CurrentSince Oct 17, 2015 Accepting new patients
Grady Memorial Hospital Corporation CurrentSince Oct 17, 2015 Accepting new patients

Locations

80 Jesse Hill Jr Dr SE
Atlanta, GA 30303
Phone (404) 616-4370

Organizations & group practices 2

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": "1155772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184716800000",
    "number": "1407969058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1306 JANMAR RD",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300782103",
            "telephone_number": "770-979-1154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1525 CLIFTON RD NE",
            "address_2": "SUITE 207",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303224200",
            "telephone_number": "404-778-4451",
            "fax_number": "404-778-4355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIRTH",
        "first_name": "DIANE",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "ANP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-17",
        "last_updated": "2007-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "GA",
            "license": "RN108564 NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.