Active NPI
Gwendolyn Bettina Nettles-Buckley, FNP
- Family Nurse Practitioner
- Albany, GA
National Provider Identifier
1780337584
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- GAA-NP000463
- Practice address
- 1200 N Jefferson St
Albany, GA 31701-2057 - Phone
- (229) 888-3970
- NPI assigned
- Feb 1, 2022
- 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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | GAA-NP000463 | GA | Primary |
Addresses
Primary practice location
1200 N Jefferson St
Albany, GA 31701-2057
Mailing address
1010 Relswood Ter
Albany, GA 31707-3635
Phone (228) 627-1884
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)
- Enrolled
- Credentials
- Nurse Practitioner
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1643673600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1643673600000",
"number": "1780337584",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1010 RELSWOOD TER",
"city": "ALBANY",
"state": "GA",
"postal_code": "317073635",
"telephone_number": "228-627-1884"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1200 N JEFFERSON ST",
"city": "ALBANY",
"state": "GA",
"postal_code": "317012057",
"telephone_number": "229-888-3970"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NETTLES-BUCKLEY",
"first_name": "GWENDOLYN",
"middle_name": "BETTINA",
"name_prefix": "Mrs.",
"credential": "FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-02-01",
"last_updated": "2022-02-01",
"certification_date": "2022-02-01",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "GA",
"license": "GAA-NP000463",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Albany, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.