Individual provider Active NPI

Reena T Gusick, PA

  • Physician Assistant
  • Atlanta, GA
National Provider Identifier
1033470075
Registry record updated Aug 31, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
006516 Issued in GA
Practice address
1100 Johnson Ferry Rd Ste 600
Atlanta, GA 30342-1739
Phone
(404) 256-4777
Fax
(404) 256-5515
NPI assigned
Jun 6, 2012
Last updated
Aug 31, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 31, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 006516 GA Primary
Medical Physician Assistant 363AM0700X NU

Addresses

Primary practice location

1100 Johnson Ferry Rd Ste 600
Atlanta, GA 30342-1739

Mailing address

1835 Savoy Dr Ste 300
Atlanta, GA 30341-1071
Phone (404) 256-4777

Other identifiers 2

IdentifierTypeStateIssuer
003126804KMedicaidGA
202I978507OtherGAMEDICARE PTAN

Other names 1

  • Reena Taank Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address reena.gusick.p1@direct.gacancer.nextgenshare.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
006516GAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
NSH Cancer Institute Professional Services G, LLC Past Accepting new patients
First Class Healthcare LLC PastSince Sep 20, 2022 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: reena.gusick.p1@direct.gacancer.nextgenshare.com

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1338940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598832000000",
    "number": "1033470075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1835 SAVOY DR STE 300",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303411071",
            "telephone_number": "404-256-4777",
            "fax_number": "404-256-5515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 JOHNSON FERRY RD STE 600",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421739",
            "telephone_number": "404-256-4777",
            "fax_number": "404-256-5515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUSICK",
        "first_name": "REENA",
        "middle_name": "T",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-06",
        "last_updated": "2020-08-31",
        "certification_date": "2020-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "006516",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003126804K",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "202I978507",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "reena.gusick.p1@direct.gacancer.nextgenshare.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct Edge",
            "address_1": "1100 Johnson Ferry Rd Ste 600",
            "city": "Atlanta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "303421739",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "REENA",
            "last_name": "TAANK",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.