Individual provider Active NPI

Courtney Hutchinson, PA-C

  • Physician Assistant
  • Marietta, GA
National Provider Identifier
1104664192
Registry record updated Jul 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
620 Cherokee St NE Ste 300
Marietta, GA 30060-7233
Phone
(770) 635-1812
NPI assigned
Jul 16, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X Primary

Addresses

Primary practice location

620 Cherokee St NE Ste 300
Marietta, GA 30060-7233

Mailing address

4150 Union Hill Rd
Canton, GA 30115-7143
Phone (770) 403-7905

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
I20241025003746 GA Practitioner - Physician Assistant 9638602832 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Piedmont Orthopedics, LLCGroup PAC ID 4385963172, 191 clinicians

Practice addresses (Care Compare)

1800 Howell Mill Rd NW
Suite 200
Atlanta, GA 30318-0917
Phone (404) 352-1015

1968 Peachtree Rd NW
Atlanta, GA 30309-1281
Phone (404) 352-1053

455 Legends PL SE
Suite 890
Atlanta, GA 30339-4245
Phone (404) 418-9090

620 Cherokee St NE
Suite 300
Marietta, GA 30060-7202
Phone (770) 635-1812

Hospital & facility affiliations

  • Piedmont Hospital, Inc Hospital, Atlanta, GA, CCN 110083

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Orthoatlanta, LLC Multi-Specialty CurrentSince Oct 14, 2024 Accepting new patients
Orthoatlanta, LLC Multi-Specialty CurrentSince Oct 14, 2024 Accepting new patients
Orthoatlanta, LLC Multi-Specialty Past Accepting new patients

Locations

900 Circle 75 Pkwy SE
Ste 1700
Atlanta, GA 30339
Phone (770) 953-6929

1265 Highway 54 W
Ste 308
Fayetteville, GA 30214
Phone (678) 216-0771

620 Cherokee St NE
Ste 300
Marietta, GA 30060
Phone (770) 635-1812

Organizations & group practices 5

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": "1721088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721088000000",
    "number": "1104664192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4150 UNION HILL RD",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301157143",
            "telephone_number": "770-403-7905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 CHEROKEE ST NE STE 300",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300607233",
            "telephone_number": "770-635-1812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUTCHINSON",
        "first_name": "COURTNEY",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-07-16",
        "last_updated": "2024-07-16",
        "certification_date": "2024-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

Verify at the official NPI Registry.