Individual provider Active NPI

Noelle Ann Celis Burkholder, NP

  • Family Nurse Practitioner
  • Marietta, GA
National Provider Identifier
1518678994
Registry record updated Jun 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN271215 Issued in GA
Practice address
1810 White Cir
Marietta, GA 30066-5835
Phone
(678) 797-6820
NPI assigned
Dec 7, 2022
Last updated
Jun 11, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN271215 GA Primary
Emergency Registered Nurse 163WE0003X RN271215 GA

Addresses

Primary practice location

1810 White Cir
Marietta, GA 30066-5835

Mailing address

1810 White Cir
Marietta, GA 30066-5835
Phone (478) 228-6407

Other practice location 1

1165 Sanders Rd
Cumming, GA 30041-5965
Phone (470) 533-4200

Other names 1

  • Miss Noelle Ann Bucariza Former name

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
I20230815000970 GA Practitioner - Nurse Practitioner 5294197828 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellstar Medical Group LLCGroup PAC ID 6709065402, 3,059 clinicians

Practice addresses (Care Compare)

1810 White Cir
Suite 105
Marietta, GA 30066-5836
Phone (678) 797-6820

5150 Stilesboro N W Rd
Suite 220
Kennesaw, GA 30152-7742
Phone (770) 424-8222

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN271215GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Omni Virtual Health Care Inc CurrentSince Jul 8, 2023 Accepting new patients
Wellstar Medical Group, LLC CurrentSince Feb 1, 2025 Accepting new patients
Wellstar Medical Group, LLC Current Accepting new patients
Georgia Woundcare MD LLC PastSince Oct 1, 2024 Accepting new patients
Wellstar Cardiovascular Medicine, LLC PastSince Feb 23, 2025 Accepting new patients

Locations

1165 Sanders Rd
Cumming, GA 30041
Phone (210) 379-8553

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

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": "1670371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749600000000",
    "number": "1518678994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1810 WHITE CIR",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300665835",
            "telephone_number": "478-228-6407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1810 WHITE CIR",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300665835",
            "telephone_number": "678-797-6820"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1165 Sanders Rd",
            "address_purpose": "LOCATION",
            "city": "Cumming",
            "state": "GA",
            "postal_code": "300415965",
            "country_code": "US",
            "telephone_number": "470-533-4200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BURKHOLDER",
        "first_name": "NOELLE ANN",
        "middle_name": "CELIS",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-07",
        "last_updated": "2025-06-11",
        "certification_date": "2025-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN271215",
            "primary": true
        },
        {
            "code": "163WE0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Emergency",
            "state": "GA",
            "license": "RN271215",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NOELLE",
            "last_name": "BUCARIZA",
            "middle_name": "ANN",
            "prefix": "MISS",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Marietta, GA

Sources for this page

Verify at the official NPI Registry.