Active NPI
James V Waldron, PA-C
- Physician Assistant
- Austell, GA
National Provider Identifier
1215054853
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 004817
- Practice address
- 3820 Medical Park Dr
Austell, GA 30106-1110 - Phone
- (770) 948-6041
- Fax
- (770) 739-5411
- NPI assigned
- Mar 26, 2007
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 004817 | GA | Primary |
Addresses
Primary practice location
3820 Medical Park Dr
Austell, GA 30106-1110
Mailing address
3820 Medical Park Dr
Austell, GA 30106-1110
Phone (770) 948-6041
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100831000626 | GA | Practitioner - Physician Assistant | 0749304533 | Reassigns benefits to 3 organizations |
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Medical College of Georgia School of Medicine, 2006
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Piedmont Providers LLC
Practice addresses (Care Compare)
1984 Peachtree Rd NW
Suite 300
Atlanta, GA 30309-5219
Phone (404) 367-3210
3820 Medical Park Dr
Austell, GA 30106-1110
Phone (770) 948-6041
Hospital & facility affiliations
- Piedmont Hospital, Inc
Merit-based Incentive Payment System (MIPS)
- Final score
- 91.62 of 100
- Quality
- 83.25
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 004817 | GA | MD | Pediatric Physical Therapist |
Organizations & group practices 3
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.
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": "1174867200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1453852800000",
"number": "1215054853",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3820 MEDICAL PARK DR",
"city": "AUSTELL",
"state": "GA",
"postal_code": "301061110",
"telephone_number": "770-948-6041",
"fax_number": "770-739-5411"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3820 MEDICAL PARK DR",
"city": "AUSTELL",
"state": "GA",
"postal_code": "301061110",
"telephone_number": "770-948-6041",
"fax_number": "770-739-5411"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALDRON",
"first_name": "JAMES",
"middle_name": "V",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-26",
"last_updated": "2016-01-27",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "GA",
"license": "004817",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Austell, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2016; 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.