Individual provider Active NPI

Brianna Monique Molina

  • Physician Assistant
  • Tucker, GA
National Provider Identifier
1124703350
Registry record updated Dec 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
2227 Idlewood Rd Ste 1
Tucker, GA 30084-4827
Phone
(678) 205-2039
NPI assigned
Jun 15, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2025

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 Primary

Addresses

Primary practice location

2227 Idlewood Rd Ste 1
Tucker, GA 30084-4827

Mailing address

6020 River View Rd SE Apt 9115
Mableton, GA 30126-3247

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
I20250617003089 GA Practitioner - Physician Assistant 2365953239 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Palmetto Health Council Inc CurrentSince Apr 1, 2025 Accepting new patients

Locations

643 Main St
Palmetto, GA 30268
Phone (404) 929-8824

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BAGADD/Endpoint/BAGADD

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1686787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764892800000",
    "number": "1124703350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6020 RIVER VIEW RD SE APT 9115",
            "city": "MABLETON",
            "state": "GA",
            "postal_code": "301263247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2227 IDLEWOOD RD STE 1",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300844827",
            "telephone_number": "678-205-2039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOLINA",
        "first_name": "BRIANNA",
        "middle_name": "MONIQUE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-15",
        "last_updated": "2025-12-05",
        "certification_date": "2025-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucker, GA

Sources for this page

Verify at the official NPI Registry.