Kenneth L Norris, P.A.

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

002268 Issued in GA

Practice address

631 Professional Dr
Suite 200
Lawrenceville, GA 30046-3367

Phone

(678) 312-3500

Fax

(678) 312-3529

NPI assigned

Sep 16, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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 Alabama School of Medicine, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Gwinnett Physician Group, LLCGroup PAC ID 9133211139, 112 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northside Hospital Gwinnett Hospital, Lawrenceville, GA, CCN 110087

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Gwinnett Physician Group, LLC

  • Internal Medicine Physician
  • Lawrenceville, GA
  • NPI 1578574661
  Medicare reassignment Care Compare group
• Peachatree Cardiovascular & Thoracic Surgeons, P.a.

  • Specialist
  • Atlanta, GA
  • NPI 1689639080
  NPD (past)
• Peachtree Cardiovascular Surgeons at Saint Joseph'S LLC

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Atlanta, GA
  • NPI 1093021172
  NPD (past)
• East Tennessee Cardiovascular Surgery Group, P.C

  • Contractor
  • Knoxville, TN
  • NPI 1679525448
  NPD (past)
• Maury Regional Hospital

  • Clinic/Center
  • Hohenwald, TN
  • NPI 1023038122
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Northside Hospital, Inc.

  • General Acute Care Hospital
  • Lawrenceville, GA
  • NPI 1952340994
  Care Compare affiliation

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

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600214400000",
    "number": "1205932175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 116156",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303686156",
            "telephone_number": "470-325-0100",
            "fax_number": "470-325-0193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "631 PROFESSIONAL DR",
            "address_2": "SUITE 200",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300463367",
            "telephone_number": "678-312-3500",
            "fax_number": "678-312-3529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NORRIS",
        "first_name": "KENNETH",
        "middle_name": "L",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-16",
        "last_updated": "2020-09-16",
        "certification_date": "2020-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "GA",
            "license": "002268",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kenneth.norris.p2@direct.gmg.nextgenshare.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct Edge",
            "address_1": "631 Professional Dr",
            "address_2": "Suite 200",
            "city": "Lawrenceville",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300463367",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Meghan Noggle, M.ED.
• Lakshmipathi Gupta Nomula, MD FACP
• Jaylen Nora
• Timothy Howard Norman, RPH
• Alexandra Frances Norris, MSN, FNP-C
• North Atlanta Endocrinology and Diabetes, PC
• North Atlanta Medical Clinic, L.L.C
• North Atlanta Neurological Services, LLC
• North Atlanta Oncology Services LLC
• North Atlanta Podiatry Group P.C.

• Surgical Physician Assistant in Lawrenceville, GA
• Providers in Lawrenceville, GA by specialty
• Surgical Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2020; 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.