Active NPI
Dana Buck Irwin, N.P.
- Pediatric Nurse Practitioner
- Jefferson, GA
National Provider Identifier
1700035797
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- RN129153
- Practice address
- 2610 Highway 129 N
Jefferson, GA 30549-2652 - Phone
- (706) 367-1010
- Fax
- (706) 367-1050
- NPI assigned
- Sep 15, 2008
- Last updated
- Mar 5, 2012
- 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 |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | RN129153 | GA | Primary |
Addresses
Primary practice location
2610 Highway 129 N
Jefferson, GA 30549-2652
Mailing address
2610 Highway 129 N
Jefferson, GA 30549-2652
Phone (706) 367-1010
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000875938B | Medicaid | GA | |
| 1336411347 | Medicaid | GA |
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)
- Not enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN129153 | GA | MD | Pediatric Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1221436800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1330905600000",
"number": "1700035797",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2610 HIGHWAY 129 N",
"city": "JEFFERSON",
"state": "GA",
"postal_code": "305492652",
"telephone_number": "706-367-1010",
"fax_number": "706-367-1050"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2610 HIGHWAY 129 N",
"city": "JEFFERSON",
"state": "GA",
"postal_code": "305492652",
"telephone_number": "706-367-1010",
"fax_number": "706-367-1050"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IRWIN",
"first_name": "DANA",
"middle_name": "BUCK",
"credential": "N.P.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-09-15",
"last_updated": "2012-03-05",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "GA",
"license": "RN129153",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000875938B",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1336411347",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Jefferson, GA
- Holly Hughes, RDMS, RVT, RDCS
- Georgia Cameron Hutchins, APRN,BC
- Independent Physical Therapy of Ga, LLC (Benchmark PT)
- Infinite Consulting Empire, LLC (Infinite Imaging)
- Integrity Counseling and Personal Development LLC
- Jackson County B O C (Jackson County Emergency Services)
- Jackson County Health Department (Jackson Co BD of HLTH)
- Jackson County Health Department
- Jackson County Health Department
- Jackson County School System
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.