WILDWINE BELIZAIRE (FNP) – Nurse Practitioner, NPI 1356032056

WILDWINE BELIZAIRE (FNP) is a healthcare provider. based in Sandy springs, Georgia. specializing in NURSE PRACTITIONER. They hold the professional credentials FNP. They hold a License No. RN315873 (GA). The NPI Number for WILDWINE BELIZAIRE (FNP) is 1356032056

Main info

Female
4 Years Of Experience
Accepts Medicare Assignment
Name
WILDWINE BELIZAIRE (FNP)
NPI
1356032056
Phone
Not provided
Address
6919 PEACHTREE DUNWOODY RD APT 346
Enumeration Date
15 May 2023
Last Update Date
15 May 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7062532441
Graduation Year
2022 (4 years ago)
PAC ID
1052831195
Group Practice PAC ID
3779842729
Professional Enrollment ID
I20250220000255
Address ID
GA301431910JA1350XSTXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience30
Completeness75
Years active:3State licenses:1Digital endpointsOther names

9,652 NURSE PRACTITIONER in GA

Provider Addresses for WILDWINE BELIZAIRE (FNP)

  • 6919 PEACHTREE DUNWOODY RD APT 346

    SANDY SPRINGS, GA 303281732

    Phone:

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-02-20

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250220000255INurse PractitionerGATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 30328)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 3779842729View full group profile
NameSpecialtyState
-KY
Nurse PractitionerTN
Nurse PractitionerFL
Nurse PractitionerGA
Nurse PractitionerGA
Nurse PractitionerFL
Nurse PractitionerKY
Nurse PractitionerGA
Nurse PractitionerGA
-SC

Reviews

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Frequently asked questions

What number should I use to identify WILDWINE BELIZAIRE (FNP) for billing?
Administrative and clinical systems typically use NPI 1356032056 for WILDWINE BELIZAIRE (FNP).
Does the public listing show WILDWINE BELIZAIRE (FNP) as active?
WILDWINE BELIZAIRE (FNP)'s NPI record reflects an active status in NPPES.
What type of care does WILDWINE BELIZAIRE (FNP) provide?
WILDWINE BELIZAIRE (FNP)'s profile centers on Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What geographic area is tied to WILDWINE BELIZAIRE (FNP)?
WILDWINE BELIZAIRE (FNP) is associated with Sandy Springs, Georgia in the same public data insurers reference.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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