Individual provider Active NPI

Amber H Herring, PA-C

  • Medical Physician Assistant
  • Austell, GA
National Provider Identifier
1467770156
Registry record updated May 6, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
5717 Issued in GA
Practice address
3820 Medical Park Dr
Austell, GA 30106-1110
Phone
(770) 948-5409
Fax
(770) 948-7994
NPI assigned
May 6, 2010
Last updated
May 6, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 5717 GA Primary

Addresses

Primary practice location

3820 Medical Park Dr
Austell, GA 30106-1110

Mailing address

3820 Medical Park Dr
Austell, GA 30106-1110
Phone (770) 948-5409

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.
Opted out of Medicare
Yes, effective Jul 1, 2026 through Jul 1, 2028

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100915000257 GA Practitioner - Physician Assistant 3072638014 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5717GAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Athens Clarke Medical Enterprises LLC CurrentSince Apr 1, 2020 Accepting new patients

Locations

1230 Baxter St
Athens, GA 30606
Phone (706) 364-3100

5401 Lake Oconee Pkwy
Greensboro, GA 30642
Phone (706) 453-7331

Interoperability endpoints

  • Direct secure messaging: aherring2018343@direct.trinity-health.org
  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1273104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1273104000000",
    "number": "1467770156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3820 MEDICAL PARK DR",
            "city": "AUSTELL",
            "state": "GA",
            "postal_code": "301061110",
            "telephone_number": "770-948-5409",
            "fax_number": "770-948-7994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3820 MEDICAL PARK DR",
            "city": "AUSTELL",
            "state": "GA",
            "postal_code": "301061110",
            "telephone_number": "770-948-5409",
            "fax_number": "770-948-7994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERRING",
        "first_name": "AMBER",
        "middle_name": "H",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-06",
        "last_updated": "2010-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": "5717",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austell, GA

Sources for this page

Verify at the official NPI Registry.