Individual provider Active NPI

Cydney Wilbanks, PA-C

  • Physician Assistant
  • Woodstock, GA
National Provider Identifier
1568990885
Registry record updated Aug 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10725 Issued in GA
Practice address
7820 Hickory Flat Hwy
Woodstock, GA 30188-2099
Phone
(678) 672-5100
NPI assigned
May 31, 2017
Last updated
Aug 9, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9110326
Physician Assistant 363A00000X 10725 GA Primary

Addresses

Primary practice location

7820 Hickory Flat Hwy
Woodstock, GA 30188-2099

Mailing address

1825 Highway 34 E Ste 1200
Newnan, GA 30265-6416

Other identifiers 1

IdentifierTypeStateIssuer
1568990885OtherFLNPI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, GA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20171205001442 FL Practitioner - Physician Assistant 4880951532 Reassigns benefits to 1 organization
I20211014001158 GA Practitioner - Physician Assistant 4880951532 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellstreet of Georgia PCGroup PAC ID 7517126279, 425 clinicians

Practice addresses (Care Compare)

2292 Peachtree Rd
Atlanta, GA 30309-1147
Phone (404) 382-9941

285 Ridgewalk Pkwy
Suite 108
Woodstock, GA 30188-4964
Phone (470) 276-9505

7820 Hickory Flat Hwy
Woodstock, GA 30188-2099
Phone (404) 353-5181

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10725GAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Wellstreet of Georgia PC CurrentSince Sep 1, 2021 Accepting new patients

Locations

2292 Peachtree Rd NW
Atlanta, GA 30309
Phone (404) 382-9941

1825 Highway 34 E
Ste 1200
Newnan, GA 30265
Phone (770) 502-2121

7820 Hickory Flat Hwy
Woodstock, GA 30188
Phone (678) 672-5100

Organizations & group practices 2

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": "1496188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691539200000",
    "number": "1568990885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1825 HIGHWAY 34 E STE 1200",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302656416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7820 HICKORY FLAT HWY",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301882099",
            "telephone_number": "678-672-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILBANKS",
        "first_name": "CYDNEY",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-31",
        "last_updated": "2023-08-09",
        "certification_date": "2023-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": "PA9110326",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "10725",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1568990885",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodstock, GA

Sources for this page

Verify at the official NPI Registry.