Individual provider Active NPI

James Wesley Garrett, PA

  • Physician Assistant
  • Marietta, GA
National Provider Identifier
1447681218
Registry record updated Sep 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
007346 Issued in GA
Practice address
790 Church St NE
Ste 400
Marietta, GA 30060-7282
Phone
(770) 952-8899
Fax
(678) 581-3680
NPI assigned
Dec 4, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2016

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 PA08783 TX
Physician Assistant 363A00000X 007346 GA Primary

Addresses

Primary practice location

790 Church St NE
Ste 400
Marietta, GA 30060-7282

Mailing address

PO Box 3157
Indianapolis, IN 46206-3157
Phone (855) 871-1526

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
I20150305000837 GA Practitioner - Physician Assistant 4688997695 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northside Urgent Care Holding LLCGroup PAC ID 4587984695, 77 clinicians

Practice addresses (Care Compare)

684 Sixes Rd
125A
Holly Springs, GA 30115-8758
Phone (678) 426-5450

81 Northside Dawson Dr
Suite 100a
Dawsonville, GA 30534-7166
Phone (706) 216-6000

900 Towne Lake Pkwy
Suite 104
Woodstock, GA 30189-1603
Phone (770) 772-1830

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
007346GAMDPhysician Assistant
PA08783TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Northside Primary Care Professional Services,LLC Past Accepting new patients

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": "1386115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474934400000",
    "number": "1447681218",
    "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": "855-871-1526",
            "fax_number": "855-277-8543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "790 CHURCH ST NE",
            "address_2": "STE 400",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300607282",
            "telephone_number": "770-952-8899",
            "fax_number": "678-581-3680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARRETT",
        "first_name": "JAMES",
        "middle_name": "WESLEY",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-12-04",
        "last_updated": "2016-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA08783",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "007346",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

Verify at the official NPI Registry.