Individual provider Active NPI

David Sanders

  • Physician Assistant
  • Marietta, GA
National Provider Identifier
1033754072
Registry record updated Jul 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
9895 Issued in GA
Practice address
1163 Johnson Ferry Rd Ste 100
Marietta, GA 30068-2764
Phone
(404) 355-0743
NPI assigned
Nov 13, 2019
Last updated
Jul 20, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 20, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 9895 GA Primary

Addresses

Primary practice location

1163 Johnson Ferry Rd Ste 100
Marietta, GA 30068-2764

Mailing address

1163 Johnson Ferry Rd Ste 100
Marietta, GA 30068-2764

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20210413001491 GA Practitioner - Physician Assistant 2961810932 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Peachtree Orthopaedic Clinic PAGroup PAC ID 4587552963, 138 clinicians

Practice addresses (Care Compare)

1163 Johnson Ferry Rd
Suite 200
Marietta, GA 30068-2764
Phone (404) 355-0743

2001 Peachtree Rd NE
Suite 705
Atlanta, GA 30309-1476
Phone (404) 355-0743

3200 Downwood Cir NW
Suite 700
Atlanta, GA 30327-5308
Phone (404) 355-0743

5505 Peachtree Dunwoody Rd
Suite 600
Atlanta, GA 30342-1717
Phone (404) 425-1577

Merit-based Incentive Payment System (MIPS)

Final score
94.9 of 100Reported as group
Promoting interoperability
94
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Peachtree Orthopaedic Clinic P.a. CurrentSince Jul 24, 2023 Accepting new patients
Peachtree Orthopaedic Clinic CurrentSince Jul 24, 2023 Accepting new patients
Peachtree Orthopaedic Clinic PA Past Accepting new patients

Locations

2001 Peachtree Rd NE
Ste 705
Atlanta, GA 30309

Interoperability endpoints

  • Direct secure messaging: david.sanders.1@8474.direct.athenahealth.com

Organizations & group practices 4

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": "1573603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689811200000",
    "number": "1033754072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1163 JOHNSON FERRY RD STE 100",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300682764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1163 JOHNSON FERRY RD STE 100",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300682764",
            "telephone_number": "404-355-0743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDERS",
        "first_name": "DAVID",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-11-13",
        "last_updated": "2023-07-20",
        "certification_date": "2023-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "9895",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

Verify at the official NPI Registry.