Individual provider Active NPI

Brian Austin Weldon, PA-S

  • Physician Assistant
  • Rome, GA
National Provider Identifier
1255042925
Registry record updated Dec 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
100 Three Rivers Dr NE
Rome, GA 30161-4999
Phone
(706) 292-0040
Fax
(706) 378-0556
NPI assigned
Dec 13, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

100 Three Rivers Dr NE
Rome, GA 30161-4999

Mailing address

100 Three Rivers Dr NE
Rome, GA 30161-4999
Phone (706) 292-0040

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230316001102 GA Practitioner - Physician Assistant 7113391053 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rome Orthopaedic Center PCGroup PAC ID 9234121864, 17 clinicians

Practice addresses (Care Compare)

100 Three Rivers Dr NE
Rome, GA 30161-4999

Hospital & facility affiliations

National Provider Directory

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

Organizations & group practices 1

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": "1670889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670889600000",
    "number": "1255042925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 THREE RIVERS DR NE",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301614999",
            "telephone_number": "706-292-0040",
            "fax_number": "706-378-0556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 THREE RIVERS DR NE",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301614999",
            "telephone_number": "706-292-0040",
            "fax_number": "706-378-0556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELDON",
        "first_name": "BRIAN",
        "middle_name": "AUSTIN",
        "credential": "PA-S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-12-13",
        "last_updated": "2022-12-13",
        "certification_date": "2022-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rome, GA

Sources for this page

Verify at the official NPI Registry.