Individual provider Active NPI

Taylor Todd, PAC

  • Physician Assistant
  • Newnan, GA
National Provider Identifier
1306533864
Registry record updated Oct 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
11961 Issued in GA
Practice address
1200 Lower Fayetteville Rd Ste B
Newnan, GA 30265-1133
Phone
(678) 631-4610
Fax
(678) 631-4611
NPI assigned
Apr 24, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2023

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 11961 GA Primary

Addresses

Primary practice location

1200 Lower Fayetteville Rd Ste B
Newnan, GA 30265-1133

Mailing address

1200 Lower Fayetteville Rd Ste B
Newnan, GA 30265-1133
Phone (678) 631-4610

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
I20231110000137 GA Practitioner - Physician Assistant 7810344967 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aga Clinical Services, LLCGroup PAC ID 7719273838, 35 clinicians

Practice addresses (Care Compare)

1260 Hwy 54 W
Suite 103
Fayetteville, GA 30214-4525
Phone (770) 486-7000

218 Hospital Dr
Suite C
Blairsville, GA 30512-3143
Phone (855) 841-1337

550 Peachtree St NE
Suite 1600
Atlanta, GA 30308-2246
Phone (855) 841-1337

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
76.05 of 100Reported as group
Quality
39.8
Promoting interoperability
98
Improvement activities
40
Cost
82.02

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11961GAMDAnatomic Pathology & Clinical Pathology Physician

Interoperability endpoints

  • Direct secure messaging: taylor.todd@ud.eclinicaldirectplus.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.

Hospital & facility affiliations 1

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": "1682294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696809600000",
    "number": "1306533864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 LOWER FAYETTEVILLE RD STE B",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302651133",
            "telephone_number": "678-631-4610",
            "fax_number": "678-631-4611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 LOWER FAYETTEVILLE RD STE B",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302651133",
            "telephone_number": "678-631-4610",
            "fax_number": "678-631-4611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TODD",
        "first_name": "TAYLOR",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-24",
        "last_updated": "2023-10-09",
        "certification_date": "2023-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "11961",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newnan, GA

Sources for this page

Verify at the official NPI Registry.