Individual provider Active NPI

Justina Ngozi Anyanwu, NP-C

  • Adult Health Nurse Practitioner
  • Dallas, GA
National Provider Identifier
1447530605
Registry record updated Aug 31, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
RN156181 Issued in GA
Practice address
539 Hardee St
Dallas, GA 30132-4711
Phone
(770) 505-0531
Fax
(770) 485-0570
NPI assigned
Aug 19, 2011
Last updated
Aug 31, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2011

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 RN156181 GA Primary

Addresses

Primary practice location

539 Hardee St
Dallas, GA 30132-4711

Mailing address

539 Hardee St
Dallas, GA 30132-4711
Phone (770) 505-0531

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
I20120404000416 GA Practitioner - Nurse Practitioner 4587824214 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN156181GAMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wellstar Medical Group, LLC Current Accepting new patients
SHC Medical Partners of Georgia, LLC CurrentSince Sep 23, 2013 Accepting new patients
Brij Singh, MD, LLC CurrentSince Oct 1, 2021 Accepting new patients
East Clinic LLC Past Accepting new patients

Locations

54 Peachtree Park Dr NE
Atlanta, GA 30309
Phone (404) 351-6041

144 Depot St
Buchanan, GA 30113
Phone (770) 646-5512

5150 Stilesboro Rd NW
Ste 120
Kennesaw, GA 30152
Phone (678) 354-0230

5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222

12201 Bluegrass Pkwy
Louisville, KY 40299
Phone (502) 568-7364

805 N Whittington Pkwy
Ste 400
Louisville, KY 40222
Phone (502) 272-3438

805 N Whittington Pkwy
Northfield, KY 40222
Phone (502) 627-7000

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1313712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314748800000",
    "number": "1447530605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "539 HARDEE ST",
            "city": "DALLAS",
            "state": "GA",
            "postal_code": "301324711",
            "telephone_number": "770-505-0531",
            "fax_number": "770-485-0570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "539 HARDEE ST",
            "city": "DALLAS",
            "state": "GA",
            "postal_code": "301324711",
            "telephone_number": "770-505-0531",
            "fax_number": "770-485-0570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANYANWU",
        "first_name": "JUSTINA",
        "middle_name": "NGOZI",
        "name_prefix": "Mrs.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-19",
        "last_updated": "2011-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "GA",
            "license": "RN156181",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, GA

Sources for this page

Verify at the official NPI Registry.