Active NPI
Reagan Brooke Morgan, PA-C
- Dermatology Physician
- Marietta, GA
National Provider Identifier
1295413805
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- 11702
- Practice address
- 111 Marble Mill Rd NW
Marietta, GA 30060-1047 - Phone
- (770) 422-1013
- Fax
- (770) 514-5996
- NPI assigned
- Jul 5, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | 11702 | GA | Primary |
Addresses
Primary practice location
111 Marble Mill Rd NW
Marietta, GA 30060-1047
Mailing address
765 Woodbrook Way
Lawrenceville, GA 30043-6854
Phone (770) 361-1275
Other practice location 1
605 S Enota Dr NE
Gainesville, GA 30501-2437
Phone (770) 538-0208
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Mercer University School of Medicine, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
111 Marble Mill NWRD
Marietta, GA 30060-1047
111 Marble Mill Rd NW
Marietta, GA 30060-1047
Phone (770) 422-1013
130 Oakside CT
Suite a
Canton, GA 30114-2456
Phone (770) 422-1013
Merit-based Incentive Payment System (MIPS)
- Final score
- 92.21 of 100
- Quality
- 100
- Improvement activities
- 40
- Cost
- 74.03
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
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.
-
- Dermatology Physician
- Marietta, GA
- NPI 1417007212
-
- Dermatology Physician
- Gainesville, GA
- NPI 1437109899
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1688515200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1732233600000",
"number": "1295413805",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "765 WOODBROOK WAY",
"city": "LAWRENCEVILLE",
"state": "GA",
"postal_code": "300436854",
"telephone_number": "770-361-1275"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 MARBLE MILL RD NW",
"city": "MARIETTA",
"state": "GA",
"postal_code": "300601047",
"telephone_number": "770-422-1013",
"fax_number": "770-514-5996"
}
],
"practiceLocations": [
{
"address_1": "605 S Enota Dr NE",
"address_purpose": "LOCATION",
"city": "Gainesville",
"state": "GA",
"postal_code": "305012437",
"country_code": "US",
"telephone_number": "770-538-0208",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MORGAN",
"first_name": "REAGAN",
"middle_name": "BROOKE",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-07-05",
"last_updated": "2024-11-22",
"certification_date": "2024-11-22",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "GA",
"license": "11702",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Marietta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2024; 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.