Active NPI
Henry Payton, PA
- Surgical Physician Assistant
- Marietta, GA
National Provider Identifier
1164969192
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Physician Assistant
- License
- 4396
- Practice address
- 1001 Burnt Hickory Rd NW
Apt 231
Marietta, GA 30064-1368 - Phone
- (972) 185-9121
- NPI assigned
- Jan 29, 2017
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Physician Assistant | 363AS0400X | 4396 | GA | Primary |
Addresses
Primary practice location
1001 Burnt Hickory Rd NW
Apt 231
Marietta, GA 30064-1368
Mailing address
1001 Burnt Hickory Rd NW
Apt 231
Marietta, GA 30064-1368
Phone (972) 815-9121
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4396 | GA | MD | Surgical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1485648000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1485648000000",
"number": "1164969192",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1001 BURNT HICKORY RD NW",
"address_2": "APT 231",
"city": "MARIETTA",
"state": "GA",
"postal_code": "300641368",
"telephone_number": "972-815-9121"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1001 BURNT HICKORY RD NW",
"address_2": "APT 231",
"city": "MARIETTA",
"state": "GA",
"postal_code": "300641368",
"telephone_number": "972-185-9121"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAYTON",
"first_name": "HENRY",
"credential": "PA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-01-29",
"last_updated": "2017-01-29",
"status": "A"
},
"taxonomies": [
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "GA",
"license": "4396",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marietta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.