Active NPI
Justina Ngozi Anyanwu, NP-C
- Adult Health Nurse Practitioner
- Dallas, GA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Nurse Practitioner
- License
- RN156181
- 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, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN156181 | GA | MD | Adult Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wellstar Medical Group, LLC | Current | Accepting new patients | |
| SHC Medical Partners of Georgia, LLC | Current | Accepting new patients | |
| Brij Singh, MD, LLC | Current | 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.
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-
- Nurse Practitioner
- Atlanta, GA
- NPI 1639314057
-
dba WellStar Family Medicine ACW
- Family Medicine Physician
- Kennesaw, GA
- NPI 1558664003
-
- Community/Behavioral Health Agency
- Roswell, GA
- NPI 1770713117
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.