Individual provider Active NPI

Samantha Hippolyte

  • Student in an Organized Health Care Education/Training Program
  • Atlanta, GA
National Provider Identifier
1154903292
Registry record updated Apr 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
720 Westview Dr SW
Atlanta, GA 30310-1458
Phone
(404) 667-3567
NPI assigned
Apr 27, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

720 Westview Dr SW
Atlanta, GA 30310-1458

Mailing address

5947 Old Wellborn Trce
Lithonia, GA 30058-8311
Phone (404) 667-3567

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
I20230808003418 GA Practitioner - Physician Assistant 4688036627 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Morehouse School of Medicine, 2022
Medicare assignment
May accept Medicare assignment
Group practices
Peachtree Immediate Care FP, LLCGroup PAC ID 3274559323, 328 clinicians
Physiotherapy Associates IncGroup PAC ID 3577470442, shared by 50 NPIs, 1,432 clinicians
The Southeast Permanente Medical GroupGroup PAC ID 6204829013, 823 clinicians
Matrix Rehabilitation-Georgia IncGroup PAC ID 2567379498, shared by 4 NPIs, 40 clinicians

Practice addresses (Care Compare)

1025 Veterans Memorial Hwy SE
Suite 720
Mableton, GA 30126-7794
Phone (770) 732-0720

1669 Phoenix Pkwy
Suite 102
College Park, GA 30349-5462
Phone (770) 907-1023

2400 Mount Zion Pkwy
Jonesboro, GA 30236-2500
Phone (770) 603-3685

2470 Mount Zion Pkwy
BLDG 200
Jonesboro, GA 30236-2500
Phone (770) 527-9031

3495 Piedmont Rd NE
Atlanta, GA 30305-1729
Phone (404) 364-7206

9050 Peridot Pkwy
Suite E
Stockbridge, GA 30281-9417
Phone (770) 474-0540

Merit-based Incentive Payment System (MIPS)

Final score
91.62 of 100Reported as apm
Quality
83.25
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Peachtree Immediate Care FP, LLC CurrentSince Dec 18, 2025 Accepting new patients
Orthoatlanta, LLC CurrentSince Jul 31, 2023 Accepting new patients
Orthoatlanta, LLC CurrentSince Jul 31, 2023 Accepting new patients

Locations

590 Lanier Ave W
Fayetteville, GA 30214

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

3827 Jimmy Lee Smith Pkwy
Hiram, GA 30141
Phone (770) 222-8900

1025 Veterans Memorial Hwy SE
Ste 720
Mableton, GA 30126
Phone (678) 819-7870

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

Organizations & group practices 6

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": "1619481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619481600000",
    "number": "1154903292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5947 OLD WELLBORN TRCE",
            "city": "LITHONIA",
            "state": "GA",
            "postal_code": "300588311",
            "telephone_number": "404-667-3567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 WESTVIEW DR SW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303101458",
            "telephone_number": "404-667-3567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIPPOLYTE",
        "first_name": "SAMANTHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-27",
        "last_updated": "2021-04-27",
        "certification_date": "2021-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.