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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

WILDWINE BELIZAIRE FNP
NPI 1356032056
Nurse Practitioner in Fairburn, GA

Active since May 15, 2023PECOS EnrolledAccepts Medicare Assignment
7560 BUTNER RD, FAIRBURN, GA 30213(800) 266-8874(877) 366-4776 Get Directions Write a Review

NPPES record last updated: July 18, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jul 18, 2026, May 15, 2023 (2 updates tracked since 2023).

About Wildwine Belizaire Fnp NPPES

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

WILDWINE BELIZAIRE FNP (NPI 1356032056) is an individual nurse practitioner in Fairburn, Georgia, licensed in Georgia (RN315873) and active in the NPI registry since May 2023. She is enrolled in Medicare PECOS and is a graduate of Other (2022).

NPPES Registry Identity

NPI1356032056
Entity TypeIndividualFemale
Primary Taxonomy363L00000X
Provider Legal NameWILDWINE BELIZAIRECredential: FNP
Location Address7560 BUTNER RDFairburn, GA 30213-1914
Mailing Address3800 S Ocean Dr Ste 209Hollywood, FL 33019-2915 · (800) 226-8874 · Fax (877) 366-4776
Phone(800) 266-8874
Fax(877) 366-4776
Sole ProprietorNo
Medical School CMSOtherGraduated 2022
Enumeration DateMay 15, 2023
Last NPPES UpdateJuly 18, 20262 updates tracked since enumeration
NPPES CertifiedJuly 18, 2026
✔ NPI 1356032056 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
License✔ Licensed in GA · RN315873
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
7560 BUTNER RD, Fairburn, GA 30213
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Wildwine Belizaire Fnp is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1052831195
PECOS Enrollment IDI20250220000255
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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30213 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 2

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

UNITED REHAB INC.
Clinic/Center (Rehabilitation)
7560 BUTNER RD
FAIRBURN, GA 30213
Fulton County (770) 306-7878
MR. MARCUS R FISHER PTA
Physical Therapy Assistant
7560 BUTNER RD
FAIRBURN, GA 30213
Fulton County (770) 306-7878

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 Wildwine Belizaire's NPI number?

The NPI number for Wildwine Belizaire is 1356032056. It was assigned to this individual provider in the NPPES registry on May 15, 2023.

Where is Wildwine Belizaire located?

Wildwine Belizaire practices at 7560 Butner Rd, Fairburn, GA 30213. The listed phone number is (800) 266-8874.

What is Wildwine Belizaire's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Wildwine Belizaire enrolled in Medicare?

Yes. Wildwine Belizaire is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Wildwine Belizaire was last updated on July 18, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 32 days 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.