BETTY R WICKSTROM N.P.
NPI 1669405197
Nurse Practitioner - Adult Health in Atlanta, GA

Q: What is Betty Wickstrom's NPI number?

The NPI number for Betty Wickstrom is 1669405197. It was assigned to this individual provider in the NPPES registry on July 8, 2006.

Q: What is Betty Wickstrom's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Adult Health, with taxonomy code 363LA2200X.

Q: When was this NPI record last updated?

The NPPES record for Betty Wickstrom was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years 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.

Active since July 08, 2006PECOS Enrolled

960 JOHNSON FERRY RD NE, SUITE 336, ATLANTA, GA 30342(404) 252-7400(404) 252-1772 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: October 25, 2026.

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About Betty R Wickstrom N.p. NPPES

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

BETTY R WICKSTROM N.P. (NPI 1669405197) is an individual adult health provider in Atlanta, Georgia, licensed in Georgia (RN045532) and active in the NPI registry since July 2006. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1669405197

Entity TypeIndividualFemale

Primary Taxonomy363LA2200X

Provider Legal NameBETTY R WICKSTROMCredential: N.P.

Location Address960 JOHNSON FERRY RD NE, SUITE 336Atlanta, GA 30342-1631

Mailing Address960 Johnson Ferry Rd Ne, Suite 336Atlanta, GA 30342-1631 · (404) 252-7400 · Fax (404) 252-1772

Phone(404) 252-7400

Fax(404) 252-1772

Sole ProprietorNo

Enumeration DateJuly 8, 2006

Last NPPES UpdateJuly 8, 2007

✔ NPI 1669405197 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Adult HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LA2200X

License✔ Licensed in GA · RN045532

960 JOHNSON FERRY RD NE, Atlanta, GA 30342

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter Health, Ambetter of Alabama and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Betty R Wickstrom N.p. 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 Betty Wickstrom reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

North Atlanta Kidney Specialists

Same address

Nephrology

980 JOHNSON FERRY RD NE, SUITE 410
Atlanta, GA 30342

Reassigned Medicare billing, Georgia enrollment
13 clinicians in this Medicare group

NPI 1598872434 (404) 252-0256

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 30342 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 20

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

MRS. LAURA W CUMMINGS MO

Obstetrics & Gynecology

960 JOHNSON FERRY RD NE, STE 400
ATLANTA, GA 30342

Fulton County (404) 257-0170

MR. ALAN I SEGAL M.S.

Audiologist

960 JOHNSON FERRY RD NE, STE 200
ATLANTA, GA 30342

Fulton County (404) 943-0900

MRS. SONZA CURTIS PA

Physician Assistant (Medical)

960 JOHNSON FERRY RD NE, SUITE 200
ATLANTA, GA 30342

Fulton County (404) 943-0900

ADVANCED EAR NOSE AND THROAT ASSOCIATES PC

Otolaryngology

960 JOHNSON FERRY RD NE, SUITE 200
ATLANTA, GA 30342

Fulton County (404) 943-0900

DR. JACK BENSON POTTER MD

Internal Medicine (Allergy & Immunology)

960 JOHNSON FERRY RD NE, SUITE 410
ATLANTA, GA 30342

Fulton County (404) 256-3788

LEE BRIAN PADOVE M.D. LLC

Internal Medicine (Cardiovascular Disease)

960 JOHNSON FERRY RD NE, SUITE 336
ATLANTA, GA 30342

Fulton County (404) 252-7400

KATHRYN METTLER M.D.

Internal Medicine (Gastroenterology)

960 JOHNSON FERRY RD NE, SUITE 505
ATLANTA, GA 30342

Fulton County (404) 843-3104

ATLANTA INFECTIOUS DISEASE SPECIALISTS PC

Internal Medicine

960 JOHNSON FERRY RD NE, SUITE 500
ATLANTA, GA 30342

Fulton County (404) 851-0081

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 Betty Wickstrom's NPI number?

The NPI number for Betty Wickstrom is 1669405197. It was assigned to this individual provider in the NPPES registry on July 8, 2006.

Where is Betty Wickstrom located?

Betty Wickstrom practices at 960 Johnson Ferry Rd NE Suite 336, Atlanta, GA 30342. The listed phone number is (404) 252-7400.

What is Betty Wickstrom's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Adult Health, with taxonomy code 363LA2200X.

Is Betty Wickstrom enrolled in Medicare?

Yes. Betty Wickstrom is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Betty Wickstrom's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Betty Wickstrom reassigns Medicare benefits to North Atlanta Kidney Specialists (Atlanta, GA). 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 Betty Wickstrom's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Betty Wickstrom accept?

Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama, Ambetter of North Carolina and Ambetter of Tennessee list Betty Wickstrom 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 Betty Wickstrom was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years 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.