Individual provider Active NPI

Brian Patrick Murrell, PA

  • Physician Assistant
  • Monroe, GA
National Provider Identifier
1063694859
Registry record updated Jun 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
005100 Issued in GA
Practice address
705 Breedlove Dr
Suite 100
Monroe, GA 30655-2090
Phone
(770) 267-6565
NPI assigned
Dec 4, 2007
Last updated
Jun 14, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2016

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 005100 GA Primary

Addresses

Primary practice location

705 Breedlove Dr
Suite 100
Monroe, GA 30655-2090

Mailing address

758 Old Norcross Rd
Ste 175
Lawrenceville, GA 30046-3388
Phone (770) 267-6565

Other identifiers 1

IdentifierTypeStateIssuer
PSL 120146006OtherGAMUTUAL INSURANCE COMPANY

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
I20130514000465 GA Practitioner - Physician Assistant 2668619586 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Atlanta Endocrinology and Diabetes, PCGroup PAC ID 7618965146, 11 clinicians

Practice addresses (Care Compare)

771 Old Norcross Rd
Suite 200
Lawrenceville, GA 30046-4980
Phone 7703391387229

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
005100GAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Openloop Healthcare Partners PC Physician Assistant Past Accepting new patients

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": "1196726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465862400000",
    "number": "1063694859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "758 OLD NORCROSS RD",
            "address_2": "STE 175",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300463388",
            "telephone_number": "770-267-6565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 BREEDLOVE DR",
            "address_2": "SUITE 100",
            "city": "MONROE",
            "state": "GA",
            "postal_code": "306552090",
            "telephone_number": "770-267-6565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MURRELL",
        "first_name": "BRIAN",
        "middle_name": "PATRICK",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-12-04",
        "last_updated": "2016-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "005100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MUTUAL INSURANCE COMPANY",
            "identifier": "PSL 120146006",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, GA

Sources for this page

Verify at the official NPI Registry.