Active NPI
Holly Watson, CPNP
- Pediatric Nurse Practitioner
- Atlanta, GA
National Provider Identifier
1811188121
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- RN152146
- Practice address
- 1001 Johnson Fy Rd NE
Atlanta, GA 30342-1605 - Phone
- (404) 785-2008
- Fax
- (404) 785-4496
- NPI assigned
- Aug 5, 2007
- Last updated
- Jun 6, 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 |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | RN152146 | GA | Primary |
Addresses
Primary practice location
1001 Johnson Fy Rd NE
Atlanta, GA 30342-1605
Mailing address
1001 Johnson Fy Rd NE
Atlanta, GA 30342-1605
Phone (404) 785-2008
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | choa@choa.gadirect.net |
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
- Certified Pediatric Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN152146 | GA | MD | Pediatric Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wellstar Medical Group, LLC | Past | Accepting new patients | |
| Wellstar Health System, Inc. | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1186272000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1654473600000",
"number": "1811188121",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1001 JOHNSON FY RD NE",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303421605",
"telephone_number": "404-785-2008",
"fax_number": "404-785-4496"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1001 JOHNSON FY RD NE",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303421605",
"telephone_number": "404-785-2008",
"fax_number": "404-785-4496"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WATSON",
"first_name": "HOLLY",
"credential": "CPNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-08-05",
"last_updated": "2022-06-06",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "GA",
"license": "RN152146",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "choa@choa.gadirect.net",
"affiliation": "N",
"address_1": "1001 Johnson Fy Rd NE",
"city": "Atlanta",
"state": "GA",
"country_code": "US",
"postal_code": "303421605",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Atlanta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 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.