Individual provider Active NPI

Renah Jeremi Hightower, PA-C

  • Physician Assistant
  • Dublin, GA
National Provider Identifier
1285039396
Registry record updated Apr 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
007435 Issued in GA
Practice address
102 Bowling LN
Dublin, GA 31021-2502
Phone
(478) 272-0203
Fax
(478) 272-0223
NPI assigned
Oct 31, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2015

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 007435 GA Primary

Addresses

Primary practice location

102 Bowling LN
Dublin, GA 31021-2502

Mailing address

102 Bowling LN
Dublin, GA 31021-2502
Phone (478) 272-0203

Other identifiers 2

IdentifierTypeStateIssuer
003154921AMedicaidGA
003154921BMedicaidGA

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
I20191122001747 GA Practitioner - Physician Assistant 2163854597 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Medical College of Georgia School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Middle Georgia Allergy and Asthma LLCGroup PAC ID 0547585432, 3 clinicians

Practice addresses (Care Compare)

229 Industrial Blvd
Dublin, GA 31021-2969
Phone (478) 353-1058

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Dr.Soos Pediatrics, PC Past Accepting new patients
The After Owls Pediatric Care,LLC Past Accepting new patients

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": "1414713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430092800000",
    "number": "1285039396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 BOWLING LN",
            "city": "DUBLIN",
            "state": "GA",
            "postal_code": "310212502",
            "telephone_number": "478-272-0203",
            "fax_number": "478-272-0223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 BOWLING LN",
            "city": "DUBLIN",
            "state": "GA",
            "postal_code": "310212502",
            "telephone_number": "478-272-0203",
            "fax_number": "478-272-0223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIGHTOWER",
        "first_name": "RENAH",
        "middle_name": "JEREMI",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-31",
        "last_updated": "2015-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "007435",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003154921A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003154921B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dublin, GA

Sources for this page

Verify at the official NPI Registry.