Emily Manley, PA
Individual provider Active NPI Physician Assistant · Laurenceville, GA
NPI 1144544834 · NPPES record last updated Mar 27, 2012
Key facts
- NPI
- 1144544834
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 005279 (GA)
- Practice address
- 771 Old Norcross Road
Suite 260
Laurenceville, GA 30046-4981 - Phone
- (770) 962-5040
- Fax
- (770) 962-5056
- NPI assigned
- Mar 24, 2010
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Emory University School of Medicine, 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Advanced Dermatology of Georgia, LLC
Practice addresses (Care Compare)
771 Old Norcross Rd
Suite 260
Lawrenceville, GA 30046-4981
Phone (770) 962-5040
Merit-based Incentive Payment System (MIPS)
- Final score
- 94.02 of 100
- Quality
- 88.03
- Improvement activities
- 40
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110913000735 | GA | Practitioner - Physician Assistant | 2163551540 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 005279 | GA | MD | Professional Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 005279 | GA | Yes |
Addresses
Primary practice location
771 Old Norcross Road
Suite 260
Laurenceville, GA 30046-4981
Mailing address
771 Old Norcross Road
Suite 260
Laurenceville, GA 30046-4981
Phone (770) 962-5040
Other providers in Laurenceville, GA
All providers in Laurenceville, GA · Physician Assistant in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 27, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.