Mary Benton Guthrie, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

6076 Issued in GA

Practice address

755 Mount Vernon Hwy NE Ste 305
Atlanta, GA 30328-4290

Phone

(404) 446-4840

Fax

(404) 446-4841

NPI assigned

Apr 1, 2011

Last updated

Jan 9, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Physician Assistant

Education

Emory University School of Medicine, 2010

Medicare assignment

May accept Medicare assignment

Group practices

Atlanta Skin Wellness Center LLCGroup PAC ID 2163893017, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• Atlanta Skin Wellness Center LLC

  dba Atlanta Skin Wellness

  • Dermatology Physician
  • Atlanta, GA
  • NPI 1902538770
  Medicare reassignment Care Compare group
• Dermatology Affiliates, LLC

  • Specialist
  • Atlanta, GA
  • NPI 1730244872
  NPD (past)

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

{
    "created_epoch": "1301616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704758400000",
    "number": "1356630115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "755 MOUNT VERNON HWY NE STE 305",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303284290",
            "telephone_number": "404-446-4840",
            "fax_number": "404-446-4841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "755 MOUNT VERNON HWY NE STE 305",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303284290",
            "telephone_number": "404-446-4840",
            "fax_number": "404-446-4841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUTHRIE",
        "first_name": "MARY",
        "middle_name": "BENTON",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-01",
        "last_updated": "2024-01-09",
        "certification_date": "2024-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "6076",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Malaika HC Gutekunst
• Michelle Guterman, PA
• Ashley Marie Guthrie, RN
• Billye Guthrie Jr.
• Margaret Victoria Guthrie, RN, CNS
• Walter Greg Guthrie, M.D.
• Leslie Itzel Gutierrez Castro
• Juanmarco Gutierrez Gonzalez
• Gabriela Smiley Gutierrez, OD
• Jasmine Gutierrez

• Physician Assistant in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 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.

Verify at the official NPI Registry.