Individual provider Active NPI

Joanna Wilson Sutherland, NP

  • Family Nurse Practitioner
  • Atlanta, GA
National Provider Identifier
1912994690
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN110992 Issued in GA
Practice address
1200 Abernathy Rd Ste 1700
Atlanta, GA 30328-5671
Phone
(770) 325-0636
Fax
(855) 737-5542
NPI assigned
Sep 29, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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 RN110992 GA Primary

Addresses

Primary practice location

1200 Abernathy Rd Ste 1700
Atlanta, GA 30328-5671

Mailing address

333 Commerce St Ste 700
Nashville, TN 37201-1835
Phone (615) 454-9850

Other practice location 1

3000 Hospital Blvd
Roswell, GA 30076-4915
Phone (770) 751-2500

Other practice location 2

3000 Hospital Blvd
Roswell, GA 30076-4915
Phone (770) 751-2500

Other names 1

  • Mrs. Joanna Denise Wilson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, NC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20051012000724 GA Practitioner - Nurse Practitioner 8224053871 Reassigns benefits to 2 organizations
I20260414000108 NC Practitioner - Nurse Practitioner 8224053871 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

12900 Park Plaza Dr
Suite 150
Cerritos, CA 90703-9329

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN110992GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Interventional Spine and Pain Management Center, PC CurrentSince Sep 1, 2016 Accepting new patients
The Interventional Spine and Pain Management Center PC CurrentSince Sep 1, 2016 Accepting new patients
Carelon Medical Partners of Kansas, PA Past Accepting new patients

Locations

15 Medical Dr NE
Ste 301
Cartersville, GA 30121
Phone (770) 590-1078

1388 Wellbrook Cir NE
#A
Conyers, GA 30012
Phone (770) 385-7985

Interoperability endpoints

  • Direct secure messaging: jsutherland21212@carelonhealth.direct-ci.com

Organizations & group practices 5

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": "1127952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1912994690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 COMMERCE ST STE 700",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372011835",
            "telephone_number": "615-454-9850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 ABERNATHY RD STE 1700",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303285671",
            "telephone_number": "770-325-0636",
            "fax_number": "855-737-5542"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3000 Hospital Blvd",
            "address_purpose": "LOCATION",
            "city": "Roswell",
            "state": "GA",
            "postal_code": "300764915",
            "country_code": "US",
            "telephone_number": "770-751-2500",
            "fax_number": "770-751-2609",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3000 Hospital Blvd",
            "address_purpose": "LOCATION",
            "city": "Roswell",
            "state": "GA",
            "postal_code": "300764915",
            "country_code": "US",
            "telephone_number": "770-751-2500",
            "fax_number": "770-751-2609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUTHERLAND",
        "first_name": "JOANNA",
        "middle_name": "WILSON",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-29",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN110992",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOANNA",
            "last_name": "WILSON",
            "middle_name": "DENISE",
            "prefix": "MRS.",
            "credential": "FNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.