Individual provider Active NPI

Mary Helen Wysochansky, RN, FNP-BC

  • Family Nurse Practitioner
  • Americus, GA
National Provider Identifier
1811996002
Registry record updated Apr 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R085059 Issued in GA
Practice address
1610 E Forsyth St
Americus, GA 31709-3893
Phone
(229) 928-1300
Fax
(229) 928-1340
NPI assigned
Jul 19, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R085059 GA Primary

Addresses

Primary practice location

1610 E Forsyth St
Americus, GA 31709-3893

Mailing address

225 Taylor St
Americus, GA 31709-4085
Phone (229) 924-1528

Other identifiers 1

IdentifierTypeStateIssuer
REF899886977MedicaidGA

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
Registered Nurse

State licenses

LicenseStateTypeSpecialty
R085059GAMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1121731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365984000000",
    "number": "1811996002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 TAYLOR ST",
            "city": "AMERICUS",
            "state": "GA",
            "postal_code": "317094085",
            "telephone_number": "229-924-1528",
            "fax_number": "229-928-1340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1610 E FORSYTH ST",
            "city": "AMERICUS",
            "state": "GA",
            "postal_code": "317093893",
            "telephone_number": "229-928-1300",
            "fax_number": "229-928-1340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYSOCHANSKY",
        "first_name": "MARY",
        "middle_name": "HELEN",
        "credential": "RN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-19",
        "last_updated": "2013-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "R085059",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "REF899886977",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Americus, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.