Individual provider Active NPI

Jonathan Edward Riordan, PA-S

  • Physician Assistant
  • Atlanta, GA
National Provider Identifier
1295309441
Registry record updated Sep 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10479 Issued in GA
Practice address
275 Collier Rd NW Ste 300
Atlanta, GA 30309-1740
Phone
(404) 350-0009
NPI assigned
May 13, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X
Physician Assistant 363A00000X 10479 GA Primary

Addresses

Primary practice location

275 Collier Rd NW Ste 300
Atlanta, GA 30309-1740

Mailing address

1011 Ridgecrest Dr SE
Smyrna, GA 30080-4230

Other practice location 1

1968 Peachtree Rd NW
Atlanta, GA 30309-1281
Phone (770) 584-5269

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
I20210908002329 GA Practitioner - Physician Assistant 1658777107 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Mercer University School of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Piedmont Specialty Hospital Billing LLCGroup PAC ID 4183986490, 252 clinicians

Practice addresses (Care Compare)

1133 Eagles Landing Pkwy
Stockbridge, GA 30281-5085
Phone (678) 604-1000

1412 Milstead Ave NE
Conyers, GA 30012-3877
Phone (770) 918-3000

5126 Hospital Dr NE
Covington, GA 30014-2566
Phone (770) 786-7053

745 Poplar Rd
Newnan, GA 30265-1618
Phone (770) 400-1000

Hospital & facility affiliations

  • Piedmont Newton Hospital Hospital, Covington, GA, CCN 110018
  • Piedmont Rockdale Hospital Hospital, Conyers, GA, CCN 110091

National Provider Directory

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

Organizations & group practices 2

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 2

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": "1620864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631577600000",
    "number": "1295309441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 RIDGECREST DR SE",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300804230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 COLLIER RD NW STE 300",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303091740",
            "telephone_number": "404-350-0009"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1968 Peachtree Rd NW",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303091281",
            "country_code": "US",
            "telephone_number": "770-584-5269",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RIORDAN",
        "first_name": "JONATHAN",
        "middle_name": "EDWARD",
        "name_prefix": "Mr.",
        "credential": "PA-S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-13",
        "last_updated": "2021-09-14",
        "certification_date": "2021-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "10479",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.