Active NPI
Stacey Wilson, NP
- Family Nurse Practitioner
- Atlanta, GA
National Provider Identifier
1659612075
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- RN155163
- Practice address
- 275 Collier Rd NW
Suite 500
Atlanta, GA 30309-1709 - Phone
- (404) 605-2800
- Fax
- (404) 351-5983
- NPI assigned
- Mar 11, 2013
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | RN155163 | GA | Primary |
Addresses
Primary practice location
275 Collier Rd NW
Suite 500
Atlanta, GA 30309-1709
Mailing address
275 Collier Rd NW
Suite 500
Atlanta, GA 30309-1709
Phone (404) 605-2800
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
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN155163 | GA | MD | Adult Health Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1362960000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1362960000000",
"number": "1659612075",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "275 COLLIER RD NW",
"address_2": "SUITE 500",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303091709",
"telephone_number": "404-605-2800",
"fax_number": "404-351-5983"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "275 COLLIER RD NW",
"address_2": "SUITE 500",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303091709",
"telephone_number": "404-605-2800",
"fax_number": "404-351-5983"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "STACEY",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-03-11",
"last_updated": "2013-03-11",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "GA",
"license": "RN155163",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Atlanta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.