Individual provider Active NPI

Celisa Johns Paine, FNP-C

  • Nurse Practitioner
  • Rome, GA
National Provider Identifier
1629644190
Registry record updated Aug 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN249531 Issued in GA
Practice address
550 Redmond Rd NW
Rome, GA 30165-1416
Phone
(762) 235-3550
Fax
(706) 233-8515
NPI assigned
Jun 3, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN249531 GA Primary

Addresses

Primary practice location

550 Redmond Rd NW
Rome, GA 30165-1416

Mailing address

221 Technology Pkwy NW
Rome, GA 30165-1369
Phone (762) 235-1000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address celisa.paine.1@1498.direct.athenahealth.com

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
I20220908000287 GA Practitioner - Nurse Practitioner 8426432527 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
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)

176 Charles Hardy Pkwy C
Hiram, GA 30141-1836
Phone (678) 945-8200

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

Merit-based Incentive Payment System (MIPS)

Final score
83.23 of 100Reported as group
Quality
65.74
Promoting interoperability
100
Improvement activities
40
Cost
78.37

Merit-based Incentive Payment System (MIPS)

Final score
93.93 of 100Reported as apm
Quality
82.14
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN249531GAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Harbin Clinic, LLC Current Accepting new patients
Harbin Clinic, LLC CurrentSince Aug 22, 2022 Accepting new patients
Wellstar Medical Group, LLC Current Accepting new patients
Wellstar Medical Group, LLC CurrentSince Dec 1, 2023 Accepting new patients
Harbin Clinic, LLC CurrentSince Aug 22, 2022 Accepting new patients
Temple Medhealth Nurse Practitioner PastSince Jun 1, 2021 Accepting new patients
Temple Medical LLC PastSince Jun 1, 2021 Accepting new patients

Locations

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

1825 Martha Berry Blvd NW
Rome, GA 30165
Phone (706) 238-8073

550 Redmond Rd NW
Rome, GA 30165
Phone (762) 235-3550

101 Redmond Rd NW
Rome, GA 30165
Phone (706) 290-1330

221 Technology Pkwy NW
Rome, GA 30165
Phone (762) 235-1000

Interoperability endpoints

  • Direct secure messaging: celisa.paine.1@1498.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/26671/brand/1/csg/1/fhir/r4

Organizations & group practices 7

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": "1622678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661385600000",
    "number": "1629644190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 TECHNOLOGY PKWY NW",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301651369",
            "telephone_number": "762-235-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 REDMOND RD NW",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301651416",
            "telephone_number": "762-235-3550",
            "fax_number": "706-233-8515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAINE",
        "first_name": "CELISA",
        "middle_name": "JOHNS",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-03",
        "last_updated": "2022-08-25",
        "certification_date": "2022-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN249531",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "celisa.paine.1@1498.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "550 Redmond Rd NW",
            "city": "Rome",
            "state": "GA",
            "country_code": "US",
            "postal_code": "301651416",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Rome, GA

Sources for this page

Verify at the official NPI Registry.