Juanita D Wyatt-Hathaway, M.D.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

042776 Issued in GA

Practice address

5445 Meridian Marks Rd NE
Suite 350
Atlanta, GA 30342-4763

Phone

(404) 252-5196

Fax

(404) 252-2414

NPI assigned

Sep 20, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Obstetrics/Gynecology

Education

Boston University School of Medicine, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Atlanta Women'S Health Group PCGroup PAC ID 1951396639, 61 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northside Hospital Hospital, Atlanta, GA, CCN 110161

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Atlanta Women'S Health Group, P.C.

  • Specialist
  • Atlanta, GA
  • NPI 1174501902
  Medicare reassignment Care Compare group NPD
• Atlanta Women'S Health Group, P.C.

  • Obstetrics & Gynecology Physician
  • Sandy Springs, GA
  • NPI 1013971753
  NPD
• Aws Physicians, PC

  • Obstetrics & Gynecology Physician
  • Atlanta, GA
  • NPI 1669591756
  NPD (past)
• Northside Hospital, Inc.

  • General Acute Care Hospital
  • Atlanta, GA
  • NPI 1457396079
  NPD (past)
• Northside Northpoint OB GYN 2 LLC

  • Obstetrics & Gynecology Physician
  • Atlanta, GA
  • NPI 1023148616
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Northside Hospital, Inc.

  • General Acute Care Hospital
  • Atlanta, GA
  • NPI 1457396079
  Care Compare affiliation

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376265600000",
    "number": "1720185770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5780 PEACHTREE DUNWOODY ROAD",
            "address_2": "SUITE 300",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421513",
            "telephone_number": "404-303-1224",
            "fax_number": "404-303-1325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5445 MERIDIAN MARKS RD NE",
            "address_2": "SUITE 350",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303424763",
            "telephone_number": "404-252-5196",
            "fax_number": "404-252-2414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYATT-HATHAWAY",
        "first_name": "JUANITA",
        "middle_name": "D",
        "name_prefix": "Mrs.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2013-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "GA",
            "license": "042776",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000733323G",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000733323F",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Diane Rosemary Wulfsohn, PHD
• Brandon Michael Wummer, MD
• Katherine Grace Wunderle, CNM, ARNP
• Ginny Wurttemberg, CNM, MSN
• Wwltach LLC
• Glenn Wyatt III, RBT
• Rochelle Wyche
• Kellie Elise Wydrinski, PAC
• John Bradley Wyly, M.D.
• Sarah Ann Wyman, ACNP

• Obstetrics & Gynecology Physician in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Obstetrics & Gynecology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.