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BETTI RAYDEEN WILBURN
NPI 1114386307
Nurse Practitioner - Family in Roswell, GA

Active since February 16, 2016PECOS Enrolled
900 OLD ROSWELL LAKES PKWY STE 310, ROSWELL, GA 30076(888) 731-8994 Get Directions Write a Review

NPPES record last updated: December 8, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Dec 8, 2024, Dec 10, 2020, Feb 16, 2016 (3 updates tracked since 2016).

About Betti Raydeen Wilburn NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BETTI RAYDEEN WILBURN (NPI 1114386307) is an individual family provider in Roswell, Georgia, licensed in Georgia (RN146147) and active in the NPI registry since February 2016. She is enrolled in Medicare PECOS and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1114386307
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameBETTI RAYDEEN WILBURN
Location Address900 OLD ROSWELL LAKES PKWY STE 310Roswell, GA 30076-8667
Mailing Address900 Old Roswell Lakes Pkwy Ste 310Roswell, GA 30076-8667 · (888) 731-8994
Phone(888) 731-8994
Sole ProprietorYes
Enumeration DateFebruary 16, 2016
Last NPPES UpdateDecember 8, 20243 updates tracked since enumeration
NPPES CertifiedDecember 8, 2024
✔ NPI 1114386307 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
Licenses✔ Licensed in GA · RN146147✔ Licensed in GA · RN147136
900 OLD ROSWELL LAKES PKWY STE 310, Roswell, GA 30076
Open in Google Maps ↗

Secondary Practice Locations 2

Location 1139 Centre St Ph 120New York, NY 10013-4559 · Phone (888) 731-8994
Location 23636 S Geyer Rd Ste 100Saint Louis, MO 63127-1237 · Phone (888) 731-8994

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource (Common Ground Healthcare).Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Betti Raydeen Wilburn is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Betti Wilburn reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Signify Health Medical Associates, PLLC
726 mi
General Practice
4055 VALLEY VIEW LN STE 700
Dallas, TX 75244
  • Reassigned Medicare billing, Georgia enrollment
  • 488 clinicians in this Medicare group
NPI 1750845863 (972) 715-3800

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30076 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$88.06 typical visit price
range $56.84 – $172.43
Typical copayment $22.01 (range $14.21 – $43.10)
Most-billed visit code 99203
Established Patient
$100.20 typical visit price
range $18.22 – $140.40
Typical copayment $25.05 (range $4.55 – $35.10)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 13

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

YVONNE CONAWAY WHNP
Nurse Practitioner (Women's Health)
900 OLD ROSWELL LAKES PKWY STE 310
ROSWELL, GA 30076
Fulton County (111) 111-1111
MS. CYNTHIA PAYNE NP
Nurse Practitioner (Women's Health)
900 OLD ROSWELL LAKES PKWY STE 310
ROSWELL, GA 30076
Fulton County (888) 731-8994
HEATHER B. KRANTZ MD
Obstetrics & Gynecology
900 OLD ROSWELL LAKES PKWY STE 310
ROSWELL, GA 30076
Fulton County (434) 248-7508
CORSHONTA HARPER FNP-C
Nurse Practitioner (Family)
900 OLD ROSWELL LAKES PKWY STE 310
ROSWELL, GA 30076
Fulton County (888) 731-8994
GEORGANNE VOGT NP-C
Nurse Practitioner (Family)
900 OLD ROSWELL LAKES PKWY STE 310
ROSWELL, GA 30076
Fulton County (888) 731-8994
DR. VALERIE L LANIER DNP, AGPCNP-C, APRN
Nurse Practitioner (Adult Health)
900 OLD ROSWELL LAKES PKWY STE 310
ROSWELL, GA 30076
Fulton County (888) 731-8994
FLY WHEEL CENTER GA LLC
Behavior Analyst
900 OLD ROSWELL LAKES PKWY STE 310
ROSWELL, GA 30076
Fulton County (347) 661-6533
STELLA ROYETTE THOMAS
Nurse Practitioner (Family)
900 OLD ROSWELL LAKES PKWY STE 310
ROSWELL, GA 30076
Fulton County (888) 731-8994

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Betti Wilburn's NPI number?

The NPI number for Betti Wilburn is 1114386307. It was assigned to this individual provider in the NPPES registry on February 16, 2016.

Where is Betti Wilburn located?

Betti Wilburn practices at 900 Old Roswell Lakes Pkwy Ste 310, Roswell, GA 30076. The listed phone number is (888) 731-8994.

What is Betti Wilburn's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Betti Wilburn enrolled in Medicare?

Yes. Betti Wilburn is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Betti Wilburn's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Betti Wilburn reassigns Medicare benefits to Signify Health Medical Associates, PLLC (Dallas, TX). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Betti Wilburn's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Betti Wilburn accept?

Health plans from CareSource (Common Ground Healthcare) list Betti Wilburn as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Betti Wilburn was last updated on December 8, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.