Individual provider Active NPI

Whittnye Barksdale, NP-C

  • Family Nurse Practitioner
  • Dawson, GA
National Provider Identifier
1578059150
Registry record updated Aug 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN201589 Issued in GA
Practice address
771 Roundtree Dr SW Ste a
Dawson, GA 39842-1683
Phone
(229) 270-1905
Fax
(229) 270-1915
NPI assigned
Jul 6, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN201589 GA Primary

Addresses

Primary practice location

771 Roundtree Dr SW Ste a
Dawson, GA 39842-1683

Mailing address

771 Roundtree Dr SW Ste a
Dawson, GA 39842-1683
Phone (229) 270-1905

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
I20180912003488 GA Practitioner - Nurse Practitioner 1254681232 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Careconnect Health, Inc. CurrentSince Aug 2, 2022 Accepting new patients
Careconnect Health, Inc. CurrentSince Aug 2, 2022 Accepting new patients
Privia Medical Group of Georgia LLC CurrentSince Oct 3, 2022 Accepting new patients
Privia Medical Group of Georgia LLC CurrentSince Oct 3, 2022 Accepting new patients

Locations

771 Roundtree Dr SW
#A
Dawson, GA 39842
Phone (229) 270-1905

101 Yorktown Dr
Ste 100
Fayetteville, GA 30214
Phone (770) 460-4285

510 Alston St
Ste B
Richland, GA 31825
Phone (229) 887-3324

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8042/brand/1/csg/1/fhir/r4

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1530835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693180800000",
    "number": "1578059150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "771 ROUNDTREE DR SW STE A",
            "city": "DAWSON",
            "state": "GA",
            "postal_code": "398421683",
            "telephone_number": "229-270-1905",
            "fax_number": "229-270-1915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "771 ROUNDTREE DR SW STE A",
            "city": "DAWSON",
            "state": "GA",
            "postal_code": "398421683",
            "telephone_number": "229-270-1905",
            "fax_number": "229-270-1915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARKSDALE",
        "first_name": "WHITTNYE",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-06",
        "last_updated": "2023-08-28",
        "certification_date": "2023-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN201589",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dawson, GA

Sources for this page

Verify at the official NPI Registry.