Individual provider Active NPI

Brittany Park Jeffers, P.A.

  • Physician Assistant
  • Hiram, GA
National Provider Identifier
1063702900
Registry record updated Apr 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
6118 Issued in GA
Practice address
148 Bill Carruth Pkwy Ste 180
Hiram, GA 30141-3756
Phone
(770) 445-4915
NPI assigned
Apr 12, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 17, 2025

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
Physician Assistant 363A00000X 6118 GA Primary

Addresses

Primary practice location

148 Bill Carruth Pkwy Ste 180
Hiram, GA 30141-3756

Mailing address

478 Lindbergh PL NE
Apt 231
Atlanta, GA 30324-3313
Phone (919) 306-4963

Other practice location 1

478 Lindbergh Pl NE
Apt 231
Atlanta, GA 30324-3313
Phone (919) 306-4963

Other names 1

  • Brittany Gail Park Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address bjeffers608059@directwellstar.org

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
I20110628000379 GA Practitioner - Physician Assistant 2769660422 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Brody School of Medicine at East Carolina University, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellstar Medical Group LLCGroup PAC ID 6709065402, 3,059 clinicians

Practice addresses (Care Compare)

2518 Jimmy Lee Smith Pkwy
Hiram, GA 30141-2068
Phone (770) 732-4022

5150 Stilesboro N W Rd
Suite 220
Kennesaw, GA 30152-7742
Phone (770) 424-8222

Hospital & facility affiliations

  • Wellstar Paulding Medical Center Hospital, Hiram, GA, CCN 110042

Merit-based Incentive Payment System (MIPS)

Final score
94.51 of 100Reported as apm
Quality
80.61
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6118GAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Wellstar Medical Group, LLC CurrentSince Nov 1, 2024 Accepting new patients
Wellstar Medical Group, LLC CurrentSince Nov 1, 2024 Accepting new patients
The Emory Clinic Inc CurrentSince Jun 6, 2011 Accepting new patients

Locations

1365 Clifton Rd NE
Atlanta, GA 30322
Phone (404) 778-7525

101 W Ponce de Leon Ave
Ste 300
Decatur, GA 30030
Phone (404) 778-4889

148 Bill Carruth Pkwy
Ste 180
Hiram, GA 30141
Phone (770) 445-1915

5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222

Interoperability endpoints

  • Direct secure messaging: bjeffers42893@direct.emory.org

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 and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1302566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744848000000",
    "number": "1063702900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "478 LINDBERGH PL NE",
            "address_2": "APT 231",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303243313",
            "telephone_number": "919-306-4963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "148 BILL CARRUTH PKWY STE 180",
            "city": "HIRAM",
            "state": "GA",
            "postal_code": "301413756",
            "telephone_number": "770-445-4915"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "478 Lindbergh Pl NE",
            "address_2": "Apt 231",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303243313",
            "country_code": "US",
            "telephone_number": "919-306-4963",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JEFFERS",
        "first_name": "BRITTANY",
        "middle_name": "PARK",
        "credential": "P.A.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-04-12",
        "last_updated": "2025-04-17",
        "certification_date": "2025-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "6118",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bjeffers608059@directwellstar.org",
            "affiliation": "N",
            "address_1": "148 Bill Carruth Pkwy Ste 180",
            "city": "Hiram",
            "state": "GA",
            "country_code": "US",
            "postal_code": "301413756",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "BRITTANY",
            "last_name": "PARK",
            "middle_name": "GAIL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Hiram, GA

Sources for this page

Verify at the official NPI Registry.