Jeremy Bagge, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

006329 Issued in GA

Practice address

1000 Hawthorne Ave Ste J
Athens, GA 30606-2168

Phone

(706) 286-8344

Fax

(706) 286-8346

NPI assigned

Feb 28, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/GBGEBD/Endpoint/GBGEBD

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Ashford Pain Solutions, LLC

  • Interventional Pain Medicine Physician
  • Athens, GA
  • NPI 1689178170
  Medicare reassignment
• Hardeman County Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Bolivar, TN
  • NPI 1861468340

  Multi-Specialty

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1141084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708905600000",
    "number": "1023085974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 495",
            "address_2": "MEDLINK GEORGIA",
            "city": "COLBERT",
            "state": "GA",
            "postal_code": "306280459",
            "telephone_number": "706-788-3234",
            "fax_number": "706-788-2936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 HAWTHORNE AVE STE J",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306062168",
            "telephone_number": "706-286-8344",
            "fax_number": "706-286-8346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAGGE",
        "first_name": "JEREMY",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-28",
        "last_updated": "2024-02-26",
        "certification_date": "2024-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": "006329",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Wesley Bacastow, MD
• Bonnie Bachtel, CRNA
• Katherine Amelia Bacon, RN
• Rebecca J Badach, PA
• Issa Papiss Bagayogo, MD PHD
• Evan James Bagwell
• Stephanie N Bagwell, NP
• Candice A Bailey, CST
• Julia Bailey
• Laurie Bailey, LPC

• Medical Physician Assistant in Athens, GA
• Providers in Athens, GA by specialty
• Medical Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.