Mia Wyatt, CNM

Primary specialty

Obstetrics & Gynecology Nurse PractitionerTaxonomy code 363LX0001X

License

RN262082 Issued in GA

Practice address

5185 Peachtree Pkwy Ste 300
Peachtree Corners, GA 30092-6543

Phone

(770) 766-3090

NPI assigned

Oct 17, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Certified Nurse Midwife

State licenses

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/5518/brand/21/csg/361/fhir/r4

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

{
    "created_epoch": "1476662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476662400000",
    "number": "1497206361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10257 MINION CT",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300226320",
            "telephone_number": "773-620-6697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5185 PEACHTREE PKWY STE 300",
            "city": "PEACHTREE CORNERS",
            "state": "GA",
            "postal_code": "300926543",
            "telephone_number": "770-766-3090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYATT",
        "first_name": "MIA",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-17",
        "last_updated": "2016-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "GA",
            "license": "RN262082",
            "primary": false
        },
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "GA",
            "license": "RN262082",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sintria L Williams-Ragin
• Ronnie Williams Jr.
• Chrystol Wilson-Payne
• In Ka Wong
• Woundstar Healthcare LLC
• Abby Y Yang
• Jordan Yates, LPC
• Kelly Young, FNP
• Marian Monique Young
• Sheri Zager, M.D.

• Obstetrics & Gynecology Nurse Practitioner in Peachtree Corners, GA
• Providers in Peachtree Corners, GA by specialty
• Obstetrics & Gynecology Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.