Individual provider Active NPI

Yvane Margaret Wimberly, R.N.-N.P.

  • Nurse Practitioner
  • Decatur, GA
National Provider Identifier
1730258096
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN137772 Issued in GA
Practice address
497 Winn Way Ste A210
Decatur, GA 30030-1712
Phone
(404) 294-7033
Fax
(404) 296-4661
NPI assigned
Nov 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 RN137772 GA Primary

Addresses

Primary practice location

497 Winn Way Ste A210
Decatur, GA 30030-1712

Mailing address

497 Winn Way Ste A210
Decatur, GA 30030-1712
Phone (404) 294-7033

Other identifiers 1

IdentifierTypeStateIssuer
RN137772OtherGASTATE LICENCE

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
I20070321000104 GA Practitioner - Nurse Practitioner 0648373167 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Emory University School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Georgia Nephrology, LLCGroup PAC ID 4082606496, 29 clinicians

Practice addresses (Care Compare)

595 Hurricane Shoals Rd NW
Suite 100
Lawrenceville, GA 30046-8762
Phone (404) 645-7150

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN137772GAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Emory Clinic Inc CurrentSince Mar 29, 2010 Accepting new patients
Georgia Nephrology, LLC CurrentSince Nov 18, 2019 Accepting new patients

Locations

1365 Clifton Rd NE
Atlanta, GA 30322
Phone (404) 778-7525

497 Winn Way
Ste A210
Decatur, GA 30030
Phone (404) 294-7033

595 Hurricane Shoals Rd NW
Ste 100
Lawrenceville, GA 30046
Phone (404) 645-7150

Interoperability endpoints

  • Direct secure messaging: ywimberly19494@direct.acumenmd.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1730258096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "497 WINN WAY STE A210",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300301712",
            "telephone_number": "404-294-7033",
            "fax_number": "404-296-4661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "497 WINN WAY STE A210",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300301712",
            "telephone_number": "404-294-7033",
            "fax_number": "404-296-4661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIMBERLY",
        "first_name": "YVANE",
        "middle_name": "MARGARET",
        "name_prefix": "Ms.",
        "credential": "R.N.-N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN137772",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENCE",
            "identifier": "RN137772",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, GA

Sources for this page

Verify at the official NPI Registry.