Active NPI
John Wallace Wright, D.P.M.,P.C.
- Podiatrist
- Milledgeville, GA
National Provider Identifier
1508861493
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- 575
- Practice address
- 151 N Jefferson St NE
Milledgeville, GA 31061-3415 - Phone
- (478) 452-7342
- Fax
- (478) 452-7342
- NPI assigned
- Jun 16, 2005
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Podiatrist | 213E00000X | 575 | GA | Primary |
Addresses
Primary practice location
151 N Jefferson St NE
Milledgeville, GA 31061-3415
Mailing address
151 N Jefferson St NE
Milledgeville, GA 31061-3415
Phone (478) 452-7342
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 753297511A | Medicaid | GA | |
| 016-004067 | Other | IL | ILLINOIS LICENSE# |
| 80095 | Other | MS | MISSISSIPPI LICENSE# |
| 000360478A | Medicaid | GA | |
| 1124171251 | Other | GA | ORGANIZATIONAL NPI |
| 575 | Other | GA | GEORGIA LICENSE# |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 575 | GA | MD | Pastoral Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1118880000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1508861493",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "151 N JEFFERSON ST NE",
"city": "MILLEDGEVILLE",
"state": "GA",
"postal_code": "310613415",
"telephone_number": "478-452-7342",
"fax_number": "478-452-7342"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "151 N JEFFERSON ST NE",
"city": "MILLEDGEVILLE",
"state": "GA",
"postal_code": "310613415",
"telephone_number": "478-452-7342",
"fax_number": "478-452-7342"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WRIGHT",
"first_name": "JOHN",
"middle_name": "WALLACE",
"name_prefix": "Dr.",
"credential": "D.P.M.,P.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-06-16",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "GA",
"license": "575",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "753297511A",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ILLINOIS LICENSE#",
"identifier": "016-004067",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MISSISSIPPI LICENSE#",
"identifier": "80095",
"state": "MS"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000360478A",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ORGANIZATIONAL NPI",
"identifier": "1124171251",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GEORGIA LICENSE#",
"identifier": "575",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Milledgeville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.