NPIMap

Individual provider Active NPI

Janice Latrice Weatherspoon, MD

  • Nephrology Physician
  • Stockbridge, GA
National Provider Identifier
1982819330
Registry record updated Oct 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
064697 Issued in GA
Practice address
250 Village Center Pkwy
Stockbridge, GA 30281-9104
Phone
(678) 289-0508
NPI assigned
May 11, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 26500 AL
Nephrology Physician 207RN0300X 064697 GA Primary

Addresses

Primary practice location

250 Village Center Pkwy
Stockbridge, GA 30281-9104

Mailing address

250 Village Center Pkwy
Stockbridge, GA 30281-9104
Phone (678) 289-0508

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100928001105 GA Practitioner - NephrologyPractitioner - Internal Medicine 2466578307 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
University of Alabama School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern Crescent Nephrology PCGroup PAC ID 2466449269, 7 clinicians

Practice addresses (Care Compare)

250 Village Ctr Pkwy
Suite 100
Stockbridge, GA 30281-9104
Phone (678) 289-0508

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
26500ALMDNephrology Physician

Interoperability endpoints

  • Direct secure messaging: jweatherspoon38669@direct.davitaphysiciansolutions.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

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

NPI Registry JSON

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

{
    "created_epoch": "1178841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414022400000",
    "number": "1982819330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 VILLAGE CENTER PKWY",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302819104",
            "telephone_number": "678-289-0508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 VILLAGE CENTER PKWY",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302819104",
            "telephone_number": "678-289-0508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEATHERSPOON",
        "first_name": "JANICE",
        "middle_name": "LATRICE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-11",
        "last_updated": "2014-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "AL",
            "license": "26500",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "GA",
            "license": "064697",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockbridge, GA

Sources for this page

Verify at the official NPI Registry.