Individual provider Active NPI

Aimberly Reshea Sanders, PA

  • Medical Physician Assistant
  • Austell, GA
National Provider Identifier
1164057881
Registry record updated Sep 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
1700 Hospital South Dr Ste 502
Austell, GA 30106-8159
Phone
(770) 423-0595
Fax
(678) 391-5055
NPI assigned
Mar 4, 2020
Last updated
Sep 8, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2021

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 10034 GA
Medical Physician Assistant 363AM0700X Primary

Addresses

Primary practice location

1700 Hospital South Dr Ste 502
Austell, GA 30106-8159

Mailing address

100 Stoneforest Dr Ste 130
Woodstock, GA 30189-4881
Phone (678) 388-1621

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
I20201026002331 GA Practitioner - Physician Assistant 1951721299 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Morehouse School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emory Specialty Associates, LLCGroup PAC ID 3476559782, 706 clinicians

Practice addresses (Care Compare)

1821 Clifton Rd NE
Atlanta, GA 30329-4021
Phone (404) 728-6812

Hospital & facility affiliations

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
10034GAMDGeneral Practice Dentistry

Interoperability endpoints

  • Direct secure messaging: asanders68902@direct.emory.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1583280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631059200000",
    "number": "1164057881",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 STONEFOREST DR STE 130",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301894881",
            "telephone_number": "678-388-1621",
            "fax_number": "678-391-5099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 HOSPITAL SOUTH DR STE 502",
            "city": "AUSTELL",
            "state": "GA",
            "postal_code": "301068159",
            "telephone_number": "770-423-0595",
            "fax_number": "678-391-5055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDERS",
        "first_name": "AIMBERLY",
        "middle_name": "RESHEA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-04",
        "last_updated": "2021-09-08",
        "certification_date": "2021-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "10034",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austell, GA

Sources for this page

Verify at the official NPI Registry.