Individual provider Active NPI

Patricia Jo Van Brunt, PA

  • Physician Assistant
  • Atlanta, GA
National Provider Identifier
1235103326
Registry record updated Aug 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
6037 Issued in GA
Practice address
950 Battery Ave SE Ste 1216
Atlanta, GA 30339-3094
Phone
(888) 663-6331
Fax
(415) 252-7176
NPI assigned
Feb 15, 2006
Last updated
Aug 26, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 6037 GA Primary
Physician Assistant 363A00000X C0010105 MD
Medical Physician Assistant 363AM0700X MP00663 NJ

Addresses

Primary practice location

950 Battery Ave SE Ste 1216
Atlanta, GA 30339-3094

Mailing address

1 Embarcadero Ctr Ste 1900
San Francisco, CA 94111-3723
Phone (888) 663-6331

Other practice location 1

159 W. Railroad Street
Pembroke, GA 31321-0190
Phone (912) 653-2897

Other identifiers 1

IdentifierTypeStateIssuer
006037OtherGAGEORGIA MEDICAL BOARD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, GA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20101014000106 NJ Practitioner - Physician Assistant 5496947012 Reassigns benefits to 1 organization
I20241227002364 GA Practitioner - Physician Assistant 5496947012 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
C0010105MDMDPhysician Assistant
MP00663NJMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Josephs Medical Group Inc Past Accepting new patients
SJC Medical Group Inc PastSince Jul 7, 2018 Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EGDCBD

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1139961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756166400000",
    "number": "1235103326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 EMBARCADERO CTR STE 1900",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941113723",
            "telephone_number": "888-663-6331",
            "fax_number": "415-252-7176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 BATTERY AVE SE STE 1216",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303393094",
            "telephone_number": "888-663-6331",
            "fax_number": "415-252-7176"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "159 W. Railroad Street",
            "address_purpose": "LOCATION",
            "city": "Pembroke",
            "state": "GA",
            "postal_code": "313210190",
            "country_code": "US",
            "telephone_number": "912-653-2897",
            "fax_number": "912-653-4299",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VAN BRUNT",
        "first_name": "PATRICIA",
        "middle_name": "JO",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-15",
        "last_updated": "2025-08-26",
        "certification_date": "2025-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "6037",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C0010105",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NJ",
            "license": "MP00663",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GEORGIA MEDICAL BOARD",
            "identifier": "006037",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.