Individual provider Active NPI

Kyashirah Barner Wright, NP-C

  • Nurse Practitioner
  • Waycross, GA
National Provider Identifier
1740805134
Registry record updated Mar 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN230453 Issued in GA
Practice address
1720 Old Reynolds St
Waycross, GA 31501-1036
Phone
(912) 283-1359
NPI assigned
Jun 10, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2022

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 RN230453 GA Primary

Addresses

Primary practice location

1720 Old Reynolds St
Waycross, GA 31501-1036

Mailing address

1410 Roosevelt St
Waycross, GA 31503-4842
Phone (912) 281-9119

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
I20210224002235 GA Practitioner - Nurse Practitioner 9032481841 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Unison Behavioral Health CurrentSince Sep 23, 2023 Accepting new patients
Unison Behavioral Health CurrentSince Sep 23, 2023 Accepting new patients

Locations

1007 Mary St
Waycross, GA 31503
Phone (912) 284-2547

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": "1591747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646179200000",
    "number": "1740805134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1410 ROOSEVELT ST",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "315034842",
            "telephone_number": "912-281-9119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1720 OLD REYNOLDS ST",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "315011036",
            "telephone_number": "912-283-1359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WRIGHT",
        "first_name": "KYASHIRAH",
        "middle_name": "BARNER",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-10",
        "last_updated": "2022-03-02",
        "certification_date": "2022-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN230453",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waycross, GA

Sources for this page

Verify at the official NPI Registry.