Active NPI
Conswalis L. Northcutt, NP
- Adult Health Nurse Practitioner
- Warner Robins, GA
National Provider Identifier
1952751497
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Nurse Practitioner
- License
- APRN-NP203938
- Practice address
- 1719 Russell Pkwy
BLDG 700
Warner Robins, GA 31088-5763 - Phone
- (478) 328-7674
- Fax
- (478) 328-1393
- NPI assigned
- Jun 15, 2016
- 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 |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | APRN-NP203938 | GA | Primary |
Addresses
Primary practice location
1719 Russell Pkwy
BLDG 700
Warner Robins, GA 31088-5763
Mailing address
1719 Russell Pkwy
BLDG 700
Warner Robins, GA 31088-5763
Phone (478) 328-7674
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| RN203938 | Other | GA | NURSE PRACTIONER LICENSURE NUMBER |
| AG0815122 | Other | GA | CERTIFICATION NUMBER (AMERICAN ACADEMY OF NURSE PRACTITIONERS) |
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
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| APRN-NP203938 | GA | MD | Adult Health Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1465948800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1762214400000",
"number": "1952751497",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1719 RUSSELL PKWY",
"address_2": "BLDG 700",
"city": "WARNER ROBINS",
"state": "GA",
"postal_code": "310885763",
"telephone_number": "478-328-7674",
"fax_number": "478-328-1393"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1719 RUSSELL PKWY",
"address_2": "BLDG 700",
"city": "WARNER ROBINS",
"state": "GA",
"postal_code": "310885763",
"telephone_number": "478-328-7674",
"fax_number": "478-328-1393"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NORTHCUTT",
"first_name": "CONSWALIS",
"middle_name": "L.",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-06-15",
"last_updated": "2025-11-04",
"certification_date": "2025-11-04",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "GA",
"license": "APRN-NP203938",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NURSE PRACTIONER LICENSURE NUMBER",
"identifier": "RN203938",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CERTIFICATION NUMBER (AMERICAN ACADEMY OF NURSE PRACTITIONERS)",
"identifier": "AG0815122",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Warner Robins, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.