Janis N Anthony-Wade, DO
Individual provider Active NPI Family Medicine Physician · Gainesville, GA
NPI 1477587913 · NPPES record last updated Feb 3, 2016
Key facts
- NPI
- 1477587913
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 050124 (GA)
- Practice address
- 2766 Atlanta Hwy
Gainesville, GA 30504-8263 - Phone
- (770) 287-8953
- Fax
- (770) 287-8954
- NPI assigned
- Jul 10, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20060911000056 | GA | Practitioner - Family Practice | 4688678469 | Practice locations: Gainesville, GA |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 050124 | GA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lifecare EMS of Georgia, LLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 050124 | GA | Yes |
Addresses
Primary practice location
2766 Atlanta Hwy
Gainesville, GA 30504-8263
Mailing address
PO Box 6170
Gainesville, GA 30504-1077
Phone (770) 287-8953
Other names
- Janis N Anthony-Wade
Other providers in Gainesville, GA
- Ibrar Anjum
- Suman Annambhotla
- Annual Wellness Centers of America
- Annual Wellness Centers of America, LLC
- Sana Hussain Ansari
- Tooba Anwar
- Michael Ira Appel
- Sarah Applegarth
- Mary Luz Araya
- Nicholas Arceneaux
All providers in Gainesville, GA · Family Medicine Physician in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 3, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.