Individual provider Active NPI

Jay Wormer, PA

  • Physician Assistant
  • Newnan, GA
National Provider Identifier
1457062796
Registry record updated Dec 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
2201 Newnan Crossing Blvd E Ste 100
Newnan, GA 30265-2551
Phone
(770) 460-4747
Fax
(678) 673-5102
NPI assigned
Dec 7, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2022

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 Primary

Addresses

Primary practice location

2201 Newnan Crossing Blvd E Ste 100
Newnan, GA 30265-2551

Mailing address

900 Circle 75 Pkwy SE Ste 1700
Atlanta, GA 30339-3087
Phone (770) 953-6929

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
I20230329002575 GA Practitioner - Physician Assistant 9133593361 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Lincoln Mem Univ, Debusk Col of Osteopathic Med, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physiotherapy Associates IncGroup PAC ID 3577470442, shared by 50 NPIs, 1,432 clinicians
Piedmont Orthopedics, LLCGroup PAC ID 4385963172, 191 clinicians

Practice addresses (Care Compare)

335 Upper Riverdale Rd
Suite B10
Jonesboro, GA 30236-1071
Phone (770) 907-5743

620 Cherokee St NE
Suite 300
Marietta, GA 30060-7202
Phone (770) 635-1812

745 Poplar Rd
Newnan, GA 30265-1618
Phone (770) 460-4747

Hospital & facility affiliations

  • Piedmont Newnan Hospital, Inc Hospital, Newnan, GA, CCN 110229
  • Piedmont Fayette Hospital Hospital, Fayetteville, GA, CCN 110215

Merit-based Incentive Payment System (MIPS)

Final score
91.62 of 100Reported as apm
Quality
83.25
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11470GAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Orthoatlanta, LLC CurrentSince Sep 24, 2023 Accepting new patients
Orthoatlanta, LLC Physician Assistant CurrentSince Sep 24, 2023 Accepting new patients
Orthoatlanta, LLC Past Accepting new patients

Locations

900 Circle 75 Pkwy SE
Ste 1700
Atlanta, GA 30339
Phone (770) 953-6929

1265 Highway 54 W
Ste 308
Fayetteville, GA 30214
Phone (678) 216-0771

620 Cherokee St NE
Ste 300
Marietta, GA 30060
Phone (770) 635-1812

2201 Newnan Crossing Blvd E
Ste 100
Newnan, GA 30265
Phone (770) 460-4747

Organizations & group practices 4

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 2

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": "1670371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670371200000",
    "number": "1457062796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 CIRCLE 75 PKWY SE STE 1700",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303393087",
            "telephone_number": "770-953-6929",
            "fax_number": "770-953-6972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2201 NEWNAN CROSSING BLVD E STE 100",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302652551",
            "telephone_number": "770-460-4747",
            "fax_number": "678-673-5102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WORMER",
        "first_name": "JAY",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-12-07",
        "last_updated": "2022-12-07",
        "certification_date": "2022-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newnan, GA

Sources for this page

Verify at the official NPI Registry.