Vikki Alisha Nunnery, DNP

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

209016318 Issued in IL

Practice address

6600 Van Aalst Blvd
Fort Moore, GA 31905-2102

Phone

(762) 408-2273

NPI assigned

Sep 24, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Other names 1

• Ms. Vikki Alisha Varisce Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Phoebe Physician Group, Inc

  • Clinic/Center
  • Albany, GA
  • NPI 1487899464
  NPD (past)

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

{
    "created_epoch": "1411516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723334400000",
    "number": "1669874376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6600 VAN AALST BLVD",
            "city": "FORT MOORE",
            "state": "GA",
            "postal_code": "319052102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6600 VAN AALST BLVD",
            "city": "FORT MOORE",
            "state": "GA",
            "postal_code": "319052102",
            "telephone_number": "762-408-2273"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4430 Missouri Ave",
            "address_purpose": "LOCATION",
            "city": "Fort Leonard Wood",
            "state": "MO",
            "postal_code": "654739098",
            "country_code": "US",
            "telephone_number": "573-596-9795",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4301 Jones Bridge Rd",
            "address_purpose": "LOCATION",
            "city": "Bethesda",
            "state": "MD",
            "postal_code": "208144712",
            "country_code": "US",
            "telephone_number": "301-295-1764",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NUNNERY",
        "first_name": "VIKKI",
        "middle_name": "ALISHA",
        "name_prefix": "Mrs.",
        "credential": "DNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-09-24",
        "last_updated": "2024-08-11",
        "certification_date": "2024-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "IL",
            "license": "041354744",
            "primary": false
        },
        {
            "code": "171000000X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider",
            "state": "IL",
            "license": "209016318",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IL",
            "license": "041354744",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "IL",
            "license": "209016318",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VIKKI",
            "last_name": "VARISCE",
            "middle_name": "ALISHA",
            "prefix": "MS.",
            "credential": "DNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Radhakrishnan Narasimhan, M.D.
• Jennifer Suzanne Neal, OTR/L
• Ayesha Mejia Nettles, MD
• Ronald Lee Newcomb Jr., D.O.
• Chad Norton, DO
• Thomas Alexander O'Hara, DO
• Etinosa Obadagbonyi
• Matthew Obernuefemann, PA
• Emily L. Ofstun, M.D.
• Jordan Orick, MS, LAT, ATC, OTC

• Primary Care Nurse Practitioner in Fort Moore, GA
• Providers in Fort Moore, GA by specialty
• Primary Care Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.