CHRISYANA GEDMYR MEDCARE LLC
NPI 1619478013
Nurse Practitioner - Family in Villa Rica, GA
About Chrisyana Gedmyr Medcare Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
CHRISYANA GEDMYR MEDCARE LLC (NPI 1619478013) is a healthcare organization registered as a family in Villa Rica, Georgia and active in the NPI registry since February 2018. The organization holds a CLIA Waiver certificate valid through May 13, 2028 and lists Josette Etienne, Fnp-c, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Chrisyana Gedmyr Medcare Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Chrisyana Gedmyr Medcare LLC, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 11D2148498
Chrisyana Gedmyr Medcare · Villa Rica, GAFrequently 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 Chrisyana Gedmyr Medcare LLC's NPI number?
The NPI number for Chrisyana Gedmyr Medcare LLC is 1619478013. It was assigned to this organization in the NPPES registry on February 22, 2018.
Where is Chrisyana Gedmyr Medcare LLC located?
Chrisyana Gedmyr Medcare LLC is located at 403 Permian Way Ste A, Villa Rica, GA 30180. The listed phone number is (770) 771-5235.
What is Chrisyana Gedmyr Medcare LLC's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Chrisyana Gedmyr Medcare LLC enrolled in Medicare?
Yes. Chrisyana Gedmyr Medcare LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Chrisyana Gedmyr Medcare LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Chrisyana Gedmyr Medcare LLC. A 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 the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Chrisyana Gedmyr Medcare LLC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 11D2148498) is associated with this NPI, valid through May 13, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Chrisyana Gedmyr Medcare LLC accept?
Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama, Ambetter of North Carolina and Ambetter of Tennessee list Chrisyana Gedmyr Medcare LLC 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 Chrisyana Gedmyr Medcare LLC was last updated on December 28, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.
# Chrisyana Gedmyr Medcare Llc · NPI 1619478013
Family organization in Villa Rica, Georgia. Organization record, active in the CMS NPPES registry since February 22, 2018.
## Identity
- **NPI:** 1619478013 (Entity type: Organization)
- **Enumerated:** February 22, 2018
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **Organization subpart:** No
- **Authorized official:** Josette Etienne, FNP-C
## Practice location
- **Address:** 403 PERMIAN WAY STE A, Villa Rica, GA 30180-3226
- **Phone:** (770) 771-5235
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Nurse Practitioner) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** December 28, 2025
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1619478013) · Data from the CMS NPPES public registry.