Individual provider Active NPI

Janette Walsh, NP-C

  • Nurse Practitioner
  • Gainesville, GA
National Provider Identifier
1871525527
Registry record updated Sep 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN164556 Issued in GA
Practice address
974 S Enota Dr NE
Gainesville, GA 30501-2429
Phone
(770) 536-7546
Fax
(678) 343-2006
NPI assigned
Jul 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN164556 GA Primary

Addresses

Primary practice location

974 S Enota Dr NE
Gainesville, GA 30501-2429

Mailing address

974 S Enota Dr NE
Gainesville, GA 30501-2429
Phone (770) 536-7546

Other identifiers 1

IdentifierTypeStateIssuer
621349764AMedicaidGA

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20040621000139 GA Practitioner - Nurse Practitioner 2365427879 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Metroderm, P.C.Group PAC ID 8729076443, 33 clinicians

Practice addresses (Care Compare)

974 S Enota Dr NE
Gainesville, GA 30501-2429
Phone (770) 536-7546

Merit-based Incentive Payment System (MIPS)

Final score
93.93 of 100Reported as apm
Quality
82.14
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Metroderm, P.C. CurrentSince Nov 1, 2022 Accepting new patients
Metroderm, P.C. CurrentSince Nov 1, 2022 Accepting new patients

Locations

134 Ansley Dr
Ste 502
Dahlonega, GA 30533
Phone (770) 536-7546

225 Adams Dr
Demorest, GA 30535
Phone (770) 532-8438

974 S Enota Dr NE
Gainesville, GA 30501
Phone (770) 536-7546

875 Johnson Fy Rd NE
Ste 300
Sandy Springs, GA 30342
Phone (404) 257-9933

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441238400000",
    "number": "1871525527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "974 S ENOTA DR NE",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305012429",
            "telephone_number": "770-536-7546",
            "fax_number": "678-343-2006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "974 S ENOTA DR NE",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305012429",
            "telephone_number": "770-536-7546",
            "fax_number": "678-343-2006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALSH",
        "first_name": "JANETTE",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-06",
        "last_updated": "2015-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN164556",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "621349764A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, GA

Sources for this page

Verify at the official NPI Registry.