Individual provider Active NPI

Abigail Kathleen Lee, PA-C

  • Physician Assistant
  • Brookhaven, GA
National Provider Identifier
1467941799
Registry record updated Mar 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
8739 Issued in GA
Practice address
3925 Peachtree Rd NE Ste 300
Brookhaven, GA 30319-5257
Phone
(404) 231-4231
NPI assigned
May 2, 2018
Last updated
Mar 29, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2021

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 8739 GA Primary

Addresses

Primary practice location

3925 Peachtree Rd NE Ste 300
Brookhaven, GA 30319-5257

Mailing address

PO Box 102321
Atlanta, GA 30368-2321

Other practice location 1

3400 Old Milton Pkwy Ste C270
Alpharetta, GA 30005-4414
Phone (770) 442-1911

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
I20210309002161 GA Practitioner - Physician Assistant 0244561355 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
Wellstar Medical Group LLCGroup PAC ID 6709065402, 3,059 clinicians

Practice addresses (Care Compare)

1010 Johnson Ferry Rd
Marietta, GA 30068-2108
Phone (770) 579-7900

5150 Stilesboro N W Rd
Suite 220
Kennesaw, GA 30152-7742
Phone (770) 424-8222

Merit-based Incentive Payment System (MIPS)

Final score
66.93 of 100Reported as group
Quality
13.11
Promoting interoperability
100
Improvement activities
40
Cost
76.65

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

Practice roles

OrganizationSpecialtyStatusNew patients
Wellstar Medical Group, LLC CurrentSince Jan 15, 2024 Accepting new patients
Southeast Medical Group, P.C. PastSince Aug 1, 2012 Accepting new patients
Piedmont Providers LLC PastSince Apr 6, 2021 Accepting new patients

Locations

5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DIJIBA

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, 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": "1525219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616976000000",
    "number": "1467941799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 102321",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303682321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3925 PEACHTREE RD NE STE 300",
            "city": "BROOKHAVEN",
            "state": "GA",
            "postal_code": "303195257",
            "telephone_number": "404-231-4231"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3400 Old Milton Pkwy Ste C270",
            "address_purpose": "LOCATION",
            "city": "Alpharetta",
            "state": "GA",
            "postal_code": "300054414",
            "country_code": "US",
            "telephone_number": "770-442-1911",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "ABIGAIL",
        "middle_name": "KATHLEEN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-02",
        "last_updated": "2021-03-29",
        "certification_date": "2021-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "8739",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookhaven, GA

Sources for this page

Verify at the official NPI Registry.