Individual provider Active NPI

Katherine Grace Wunderle, CNM, ARNP

  • Advanced Practice Midwife
  • Atlanta, GA
National Provider Identifier
1427329994
Registry record updated Feb 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
RN247235 Issued in GA
Practice address
1100 Johnson Fy Rd NE
St 800
Atlanta, GA 30342-1709
Phone
(404) 252-1137
NPI assigned
Jan 15, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X RN247235 GA Primary

Addresses

Primary practice location

1100 Johnson Fy Rd NE
St 800
Atlanta, GA 30342-1709

Mailing address

1100 Johnson Fy Rd NE
St 800
Atlanta, GA 30342-1709
Phone (404) 252-1137

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: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Mar 1, 2016 through Mar 1, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
RN247235GAMDAdvanced Practice Midwife

NPI Registry JSON

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

{
    "created_epoch": "1326585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518480000000",
    "number": "1427329994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 JOHNSON FY RD NE",
            "address_2": "ST 800",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421709",
            "telephone_number": "404-252-1137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 JOHNSON FY RD NE",
            "address_2": "ST 800",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421709",
            "telephone_number": "404-252-1137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WUNDERLE",
        "first_name": "KATHERINE",
        "middle_name": "GRACE",
        "credential": "CNM, ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-15",
        "last_updated": "2018-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "GA",
            "license": "RN247235",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.