Kawajalein Latic Whitaker, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN224425 Issued in GA

Practice address

101 Tara Commons Dr
Loganville, GA 30052-8018

Phone

(678) 928-9701

NPI assigned

Jun 1, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA, NC, TN, VA4 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 4

Specialty

Nurse Practitioner

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hospital Physician Services - Southeast Professional CorporationGroup PAC ID 5597774554, 825 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Haywood Regional Medical Center Hospital, Clyde, NC, CCN 340184
• Memorial Mission Hospital and Asheville Surgery Ce Hospital, Asheville, NC, CCN 340002

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Hospital Physician Services - Southeast Professional Corporation

  • Hospitalist Physician
  • Monroe, GA
  • NPI 1760410385

  NC

  Medicare reassignment Care Compare group NPD
• Acs Primary Care Physicians - Southeast PC

  • Emergency Medicine Physician
  • Myrtle Beach, SC
  • NPI 1861430555

  GA

  Medicare reassignment NPD
• Southeastern Intensivist Services PC

  • Hospitalist Physician
  • West Memphis, AR
  • NPI 1912942665

  VA

  Medicare reassignment NPD
• Southeastern Medical Group, PC

  • Hospitalist Physician
  • Brevard, NC
  • NPI 1184669053
  Medicare reassignment NPD
• Southeastern Physician Services PC

  • Hospitalist Physician
  • Oak Ridge, TN
  • NPI 1083835441
  Medicare reassignment NPD
• Jakae Wellness LLC

  • Primary Care Clinic/Center
  • Atlanta, GA
  • NPI 1285561621
  NPD Authorized official

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• DLP Haywood Regional Medical Center LLC.

  • General Acute Care Hospital
  • Clyde, NC
  • NPI 1811158215
  Care Compare affiliation
• MH Mission Hospital, LLLP

  • General Acute Care Hospital
  • Asheville, NC
  • NPI 1962987677
  Care Compare affiliation

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

{
    "created_epoch": "1496275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1496275200000",
    "number": "1982132171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3531 GLEN SUMMIT LN",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300397612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 TARA COMMONS DR",
            "city": "LOGANVILLE",
            "state": "GA",
            "postal_code": "300528018",
            "telephone_number": "678-928-9701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITAKER",
        "first_name": "KAWAJALEIN",
        "middle_name": "LATIC",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-01",
        "last_updated": "2017-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN224425",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wellstreet of Georgia PC
• Wellstreet of Georgia PC
• Catrina Renee Wesley
• Elizabeth West, MSN, NP-C
• Jessica West, CCC-SLP
• Melia Nicole Whitaker, PT, DPT
• Melinda Gail Whitton, CAC 1
• Emily Wilcox
• Nakia Shante' Wilder, LMSW
• Sherri Wilder, PT

• Family Nurse Practitioner in Loganville, GA
• Providers in Loganville, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.