Individual provider Active NPI

Susan D Mills, PA

  • Physician Assistant
  • Marietta, GA
National Provider Identifier
1427585058
Registry record updated Mar 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
8815 Issued in GA
Practice address
790 Church St NE Ste 400
Marietta, GA 30060-8957
Phone
(770) 405-2976
NPI assigned
May 14, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NY
Physician Assistant 363A00000X 8815 GA Primary

Addresses

Primary practice location

790 Church St NE Ste 400
Marietta, GA 30060-8957

Mailing address

PO Box 3157
Indianapolis, IN 46206-3157
Phone (770) 405-2976

Other practice location 1

43 New Scotland Ave
Albany, NY 12208-3412
Phone (518) 262-3773

Other practice location 2

1255 Highway 54 W
Fayetteville, GA 30214-4526
Phone (770) 719-6911

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
I20180814000967 GA Practitioner - Physician Assistant 8729350350 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Quantum Radiology PCGroup PAC ID 4385543230, 105 clinicians

Practice addresses (Care Compare)

3950 Austell Rd
Austell, GA 30106-1121
Phone (770) 732-4000

677 Church St NE
Marietta, GA 30060-1101
Phone (770) 793-5000

790 Church Nest
Suite 400
Marietta, GA 30060-8957
Phone (678) 581-3830

790 Church St NE
Suite 400
Marietta, GA 30060-8957
Phone (770) 952-8899

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Georgia Em-I Medical Services PC Physician Assistant CurrentSince Jun 30, 2018 Accepting new patients

Locations

1255 Highway 54 W
Fayetteville, GA 30214
Phone (770) 719-6911

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 3

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": "1494720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741564800000",
    "number": "1427585058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3157",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462063157",
            "telephone_number": "770-405-2976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "790 CHURCH ST NE STE 400",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300608957",
            "telephone_number": "770-405-2976"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "43 New Scotland Ave",
            "address_purpose": "LOCATION",
            "city": "Albany",
            "state": "NY",
            "postal_code": "122083412",
            "country_code": "US",
            "telephone_number": "518-262-3773",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1255 Highway 54 W",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "GA",
            "postal_code": "302144526",
            "country_code": "US",
            "telephone_number": "770-719-6911",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILLS",
        "first_name": "SUSAN",
        "middle_name": "D",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-14",
        "last_updated": "2025-03-10",
        "certification_date": "2025-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "8815",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

Verify at the official NPI Registry.