Individual provider Active NPI

Fianna Ford, PA-C

  • Physician Assistant
  • Fayetteville, GA
National Provider Identifier
1255202925
Registry record updated Oct 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
13451 Issued in GA
Practice address
1336 Highway 54 W BLDG 500
Fayetteville, GA 30214-4574
Phone
(770) 461-1238
NPI assigned
Sep 16, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2025

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 13451 GA Primary

Addresses

Primary practice location

1336 Highway 54 W BLDG 500
Fayetteville, GA 30214-4574

Mailing address

1336 Highway 54 W BLDG 500
Fayetteville, GA 30214-4574

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
I20251227000671 GA Practitioner - Physician Assistant 9032605126 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Resurgens, LLCGroup PAC ID 1153224142, 184 clinicians

Practice addresses (Care Compare)

1336 Hwy 54 W
Fayetteville, GA 30214-4535
Phone (770) 461-1238

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
13451GAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Resurgens, LLC CurrentSince Dec 12, 2025 Accepting new patients
Resurgens, LLC CurrentSince Dec 12, 2025 Accepting new patients
Resurgens, LLC PastSince Mar 1, 2022 Accepting new patients

Locations

3885 Princeton Lakes Way SW
Ste 310
Atlanta, GA 30331
Phone (404) 346-9233

1336 Highway 54 W
Bldg 500
Fayetteville, GA 30214
Phone (770) 461-1238

1336 Highway 54 W
Fayetteville, GA 30214
Phone (404) 590-6890

1585 N Expressway
Griffin, GA 30223
Phone (770) 227-7050

156 Foster Dr
Ste B
McDonough, GA 30253
Phone (770) 506-4119

2301 Newnan Crossing Blvd E
Ste 100
Newnan, GA 30265
Phone (678) 333-6600

5671 Ptree Dunwoody Rd NE
Ste 900
Sandy Springs, GA 30342
Phone (404) 531-8590

Interoperability endpoints

  • Direct secure messaging: fianna.ford.1@15749.direct.athenahealth.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1757980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760054400000",
    "number": "1255202925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1336 HIGHWAY 54 W BLDG 500",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302144574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1336 HIGHWAY 54 W BLDG 500",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302144574",
            "telephone_number": "770-461-1238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORD",
        "first_name": "FIANNA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-09-16",
        "last_updated": "2025-10-10",
        "certification_date": "2025-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "13451",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, GA

Sources for this page

Verify at the official NPI Registry.