Coreyonna Durayne Whitehead, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

268388 Issued in GA

Practice address

5700 Hillandale Dr Ste 290
Lithonia, GA 30058-4120

Phone

(678) 367-3212

NPI assigned

Jun 7, 2022

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 names 1

• Coreyonna Durayne Welch Former name

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

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Twelvestone Infusion Centers LLCGroup PAC ID 6800151424, 64 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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.

• Twelvestone Infusion Centers LLC

  • Infusion Therapy Clinic/Center
  • Murfreesboro, TN
  • NPI 1447764857

  GA

  Medicare reassignment Care Compare group NPD
• Grady Memorial Hospital Corporation

  • Family Medicine Physician
  • Atlanta, GA
  • NPI 1114243813
  Medicare reassignment NPD
• Grady Memorial Hospital Corporation

  • Rehabilitation Hospital
  • Atlanta, GA
  • NPI 1336961119
  NPD

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

{
    "created_epoch": "1654560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695600000000",
    "number": "1760111660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3303 QUARTER HORSE LN",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300134400",
            "telephone_number": "678-830-6374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5700 HILLANDALE DR STE 290",
            "city": "LITHONIA",
            "state": "GA",
            "postal_code": "300584120",
            "telephone_number": "678-367-3212"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "80 Jesse Hill Jr Dr SE",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303033050",
            "country_code": "US",
            "telephone_number": "404-616-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WHITEHEAD",
        "first_name": "COREYONNA",
        "middle_name": "DURAYNE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-07",
        "last_updated": "2023-09-25",
        "certification_date": "2023-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "268388",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "COREYONNA",
            "last_name": "WELCH",
            "middle_name": "DURAYNE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Candace Charysse White, D.O., M.P.H., M.S.
• Carolyn White
• Lena White
• Sharon Jackson White, F.N.P.
• Stefan James White, RBT
• Tiffany Wiggleton
• Mary Frances Wilder
• Raven Ciara Wiley-Hunt
• Elbrenda Wiley, LCSW
• Alison P Williams

• Family Nurse Practitioner in Lithonia, GA
• Providers in Lithonia, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2023; 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.