Anthony E. Medina

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

006030 Issued in GA

Practice address

2696 Lawrenceville Suwanee Rd
Suwanee, GA 30024-2535

Phone

(678) 376-1300

Fax

(678) 514-2936

NPI assigned

Aug 11, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Physician Assistant

Education

University of Washington School of Medicine, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

DawoudGroup PAC ID 1951434422, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Dawoud

  dba North Georgia Urgent Care

  • Family Medicine Physician
  • Duluth, GA
  • NPI 1255650941
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1218412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1305676800000",
    "number": "1174779177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2696 LAWRENCEVILLE SUWANEE RD",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300242535",
            "telephone_number": "678-376-1300",
            "fax_number": "678-514-2936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2696 LAWRENCEVILLE SUWANEE RD",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300242535",
            "telephone_number": "678-376-1300",
            "fax_number": "678-514-2936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDINA",
        "first_name": "ANTHONY",
        "middle_name": "E.",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-11",
        "last_updated": "2011-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "RC60035704",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": "006030",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Claressa Ann McMurtry, LMT, MLD-C, CLT
• Deborah Ruth McNair, ARNP
• Mco Homecare Services LLC
• Meaningful Milestones, Applied Behavior Analysis, LLC
• Medex- Anesthesia Inc
• Medprime North, Inc.
• Medsmart USA DME LLC
• Lindsay Bearman Medwed, CCC-SLP
• Amy Meehan, PT, DPT, MTC
• Meeting of the Minds Therapeutic Services and Consulting, LLC

• Medical Physician Assistant in Suwanee, GA
• Providers in Suwanee, GA by specialty
• Medical Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.