DR. DIANDREA WYNN MD
NPI 1417898693
Student in an Organized Health Care Education/Training Program in Atlanta, GA
About Dr. Diandrea Wynn Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. DIANDREA WYNN MD (NPI 1417898693) is an individual student in an organized health care education/training program in Atlanta, Georgia, licensed in Georgia (112564) and active in the NPI registry since April 2026. She is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Dr. Diandrea Wynn Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
ATLANTA, GA 30322
ATLANTA, GA 30322
ATLANTA, GA 30322
ATLANTA, GA 30322
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 Diandrea Wynn's NPI number?
The NPI number for Diandrea Wynn is 1417898693. It was assigned to this individual provider in the NPPES registry on April 2, 2026.
Where is Diandrea Wynn located?
Diandrea Wynn practices at 1364 Clifton Rd NE, Atlanta, GA 30322. The listed phone number is (404) 727-5658.
What is Diandrea Wynn's specialty?
The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.
Is Diandrea Wynn enrolled in Medicare?
Yes. Diandrea Wynn is registered in the Medicare PECOS enrollment system.
When was this NPI record last updated?
The NPPES record for Diandrea Wynn was last updated on July 15, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 24 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.
# Dr. Diandrea Wynn, MD · NPI 1417898693
Student in an Organized Health Care Education/Training Program provider in Atlanta, Georgia. Individual provider, active in the CMS NPPES registry since April 2, 2026.
## Identity
- **NPI:** 1417898693 (Entity type: Individual)
- **Enumerated:** April 2, 2026
- **Primary specialty:** Student in an Organized Health Care Education/Training Program · taxonomy 390200000X
- **State license:** 112564 (Georgia)
- **Sole proprietor:** No
## Practice location
- **Address:** 1364 CLIFTON RD NE, Atlanta, GA 30322-1059
- **Phone:** (404) 727-5658
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
## Record status
- **NPPES last updated:** July 15, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1417898693) · Data from the CMS NPPES public registry.