Individual provider Active NPI

Justin Aaron Underwood

  • Acute Care Clinical Nurse Specialist
  • Atlanta, GA
National Provider Identifier
1801724083
Registry record updated May 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Clinical Nurse SpecialistTaxonomy code 364SA2100X
License
RN259763 Issued in GA
Practice address
550 Peachtree St NE
Atlanta, GA 30308-2212
Phone
(404) 686-4411
NPI assigned
May 11, 2026
Sex
Unspecified or another gender identity
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 29, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN259763 GA
Acute Care Clinical Nurse Specialist 364SA2100X RN259763 GA Primary

Addresses

Primary practice location

550 Peachtree St NE
Atlanta, GA 30308-2212

Mailing address

2094 Shady LN
Tucker, GA 30084-5509

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
RN259763GAMDAcute Care Clinical Nurse Specialist

NPI Registry JSON

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

{
    "created_epoch": "1778457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780012800000",
    "number": "1801724083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2094 SHADY LN",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300845509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 PEACHTREE ST NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303082212",
            "telephone_number": "404-686-4411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UNDERWOOD",
        "first_name": "JUSTIN",
        "middle_name": "AARON",
        "sole_proprietor": "YES",
        "sex": "X",
        "enumeration_date": "2026-05-11",
        "last_updated": "2026-05-29",
        "certification_date": "2026-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GA",
            "license": "RN259763",
            "primary": false
        },
        {
            "code": "364SA2100X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Acute Care",
            "state": "GA",
            "license": "RN259763",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.