Beretta Craft-Coffman, P.A.-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

002366 Issued in GA

Practice address

125 Oakside CT Ste 102
Canton, GA 30114-2498

Phone

(770) 213-8376

NPI assigned

Mar 2, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 11

Addresses

Medicare fee-for-service enrollment

Enrolled in GA, SC, TX, NV, VA, MS6 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 6

Specialty

Physician Assistant

Education

Other, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mississippi Burn Hand and Reconstruction Centers PCGroup PAC ID 2163891268, 13 clinicians

Champions Clinical Services LLCGroup PAC ID 6305368788, 7 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mississippi Baptist Medical Center Hospital, Jackson, MS, CCN 250102
• Doctors Hospital Hospital, Augusta, GA, CCN 110177

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Champions Clinical Services, LLC

  • Surgery Physician
  • Augusta, GA
  • NPI 1033928650
  Medicare reassignment Care Compare group
• Mississippi Burn, Hand and Reconstruction Centers PC

  • Specialist
  • Jackson, MS
  • NPI 1699484816
  Medicare reassignment Care Compare group
• Nevada Burn & Reconstruction Coates LTD

  • Surgical Critical Care Physician
  • Las Vegas, NV
  • NPI 1225725278
  Medicare reassignment NPD
• Joseph M Still Burn Centers, Inc

  • Specialist
  • Augusta, GA
  • NPI 1215904909

  SC, TX, VA

  Medicare reassignment
• Neighborhood Improvement Project Inc

  dba Medical Associates Plus

  • Primary Podiatric Medicine Podiatrist
  • Evans, GA
  • NPI 1124984224
  Medicare reassignment
• Renewal Wound Care Georgia LLC

  • Surgery Physician
  • Canton, GA
  • NPI 1558177618
  Medicare reassignment
• Renewal Wound Care Georgia LLC

  • Surgery Physician
  • Camden, SC
  • NPI 1265373997
  Medicare reassignment

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Doctors Hospital of Augusta LLC

  dba Doctors Hospital (Augusta)

  • General Acute Care Hospital
  • Augusta, GA
  • NPI 1912951963
  Care Compare affiliation
• Mississippi Baptist Medical Center, Inc.

  • General Acute Care Hospital
  • Jackson, MS
  • NPI 1710909585
  Care Compare affiliation

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

{
    "created_epoch": "1141257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750377600000",
    "number": "1285601880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "626 BENT CREEK DR",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308097445",
            "telephone_number": "706-833-8983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 OAKSIDE CT STE 102",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301142498",
            "telephone_number": "770-213-8376"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1225 N State St",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "MS",
            "postal_code": "392022064",
            "country_code": "US",
            "telephone_number": "833-672-8767",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3186 S Maryland Pkwy",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891092317",
            "country_code": "US",
            "telephone_number": "725-433-7788",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CRAFT-COFFMAN",
        "first_name": "BERETTA",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-02",
        "last_updated": "2025-06-20",
        "certification_date": "2025-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CO",
            "license": "PA.0004259",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "PA9106348",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NV",
            "license": "PA2198",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NC",
            "license": "0010-10058",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MS",
            "license": "PA00325",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "SC",
            "license": "1199",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NV",
            "license": "PA0659",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "TN",
            "license": "PA0000001672",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "TX",
            "license": "PA09999",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "VA",
            "license": "0110007147",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "GA",
            "license": "002366",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth P Covington, O.D.
• Joseph Cown
• Dawn Cox
• Louis Michael Cox, D.M.D.
• Cpmsc Canton, LLC
• Craig Wellness and Recovery
• Jacob Franklin Crandon
• Creative Therapy, Inc.
• Creative Therapy, Inc.
• Britton Crigler, MD

• Surgical Physician Assistant in Canton, GA
• Providers in Canton, GA by specialty
• Surgical Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2025; 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.

Verify at the official NPI Registry.