Individual provider Active NPI

Kristen N Busby, PA-C

  • Physician Assistant
  • Fayetteville, GA
National Provider Identifier
1386614477
Registry record updated Aug 31, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
004535 Issued in GA
Practice address
1336 Highway 54 W BLDG 500
Fayetteville, GA 30214-4574
Phone
(770) 461-1238
Fax
(770) 460-6610
NPI assigned
Jan 23, 2006
Last updated
Aug 31, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2020

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 004535 GA Primary

Addresses

Primary practice location

1336 Highway 54 W BLDG 500
Fayetteville, GA 30214-4574

Mailing address

1336 Highway 54 W BLDG 500
Fayetteville, GA 30214-4574
Phone (770) 461-1238

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
I20051007000215 GA Practitioner - Physician Assistant 8123043395 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Medical College of Georgia School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Resurgens, LLCGroup PAC ID 1153224142, 184 clinicians

Practice addresses (Care Compare)

1336 Hwy 54 W
BLDG 400 Suite C
Fayetteville, GA 30214-4574
Phone (770) 461-6142

1585 N Expressway
Griffin, GA 30223-1746
Phone (770) 227-7050

4025 Johns Creek Pkwy
Suite 100
Suwanee, GA 30024-1253
Phone (404) 575-4500

5671 Peachtree Dunwoody Rd
Suite 900
Atlanta, GA 30342-5022

5671 Peachtree Dunwoody Rd NE
Suite 900 950
Atlanta, GA 30342-5022
Phone (404) 847-9999

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.93 of 100Reported as apm
Quality
82.14
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
004535GAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Resurgens, LLC CurrentSince Aug 31, 2020 Accepting new patients
Resurgens, LLC CurrentSince Aug 31, 2020 Accepting new patients
Resurgens, LLC Past Accepting new patients
Resurgens, LLC PastSince Mar 1, 2022 Accepting new patients
Orthoatlanta, LLC Past Accepting new patients

Locations

1336 Highway 54 W
Bldg 500
Fayetteville, GA 30214
Phone (770) 461-1238

665 S 8th St
Griffin, GA 30224
Phone (770) 227-7050

156 Foster Dr
Ste B
McDonough, GA 30253
Phone (770) 506-4119

5671 Ptree Dunwoody Rd NE
Ste 900
Sandy Springs, GA 30342
Phone (404) 531-8590

Interoperability endpoints

  • Direct secure messaging: kristen.busby.1@15749.direct.athenahealth.com

Organizations & group practices 5

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.

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": "1137974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598832000000",
    "number": "1386614477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1336 HIGHWAY 54 W BLDG 500",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302144574",
            "telephone_number": "770-461-1238",
            "fax_number": "770-460-6610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1336 HIGHWAY 54 W BLDG 500",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302144574",
            "telephone_number": "770-461-1238",
            "fax_number": "770-460-6610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSBY",
        "first_name": "KRISTEN",
        "middle_name": "N",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-23",
        "last_updated": "2020-08-31",
        "certification_date": "2020-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "004535",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, GA

Sources for this page

Verify at the official NPI Registry.