Vivian M Hutton, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

002475 Issued in GA

Practice address

1551 Doctors Dr
Building 200
Lagrange, GA 30240-4139

Phone

(706) 884-2641

Fax

(706) 884-2353

NPI assigned

Sep 14, 2005

Sex

Female

Sole proprietor

No

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.

• Wellstar Medical Group, LLC

  • Family Medicine Physician
  • Kennesaw, GA
  • NPI 1558664003

  GA

  Medicare reassignment Care Compare group
• Wellstar Medical Group, LLC

  • Multi-Specialty Clinic/Center
  • Marietta, GA
  • NPI 1275992240
  Care Compare group NPD
• Southern Cardiopulmonary Associates PC

  • Specialist
  • Lagrange, GA
  • NPI 1841285004
  NPD
• Wellstar Medical Group, LLC

  • Pediatrics Physician
  • Kennesaw, GA
  • NPI 1255637211
  NPD
• West Georgia Health Physicians Inc

  • Surgery Physician
  • Lagrange, GA
  • NPI 1164711792
  NPD (past)

Specialty

Physician Assistant

Education

University of Texas Medical Branch at Galveston, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Wellstar Medical Group LLC 3,059 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

93.93 of 100Reported as apm

Quality

82.14

Promoting interoperability

100

Improvement activities

40

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Nov 5, 2019.

{
    "created_epoch": "1126656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572912000000",
    "number": "1477548626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1551 DOCTORS DR",
            "address_2": "BUILDING 200",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302404139",
            "telephone_number": "706-884-2641",
            "fax_number": "706-884-2353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1551 DOCTORS DR",
            "address_2": "BUILDING 200",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302404139",
            "telephone_number": "706-884-2641",
            "fax_number": "706-884-2353"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1602 Vernon Rd Ste 300",
            "address_purpose": "LOCATION",
            "city": "LaGrange",
            "state": "GA",
            "postal_code": "302404129",
            "country_code": "US",
            "telephone_number": "706-242-5100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HUTTON",
        "first_name": "VIVIAN",
        "middle_name": "M",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-14",
        "last_updated": "2019-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": "002475",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100000064A",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "vhutton134973@directwellstar.org",
            "affiliation": "N",
            "address_1": "1602 Vernon Rd Ste 300",
            "city": "LaGrange",
            "state": "GA",
            "country_code": "US",
            "postal_code": "302404129",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Robert Matthew Hulsey
• Rebecca Fondren Humphries, APRN
• Karyn Livingston Hunnicutt, M.D.
• Rachaele Hurd, CCC-SLP
• Hutto Limb and Brace, LLC
• Inara Health and Wellness
• Independent Physical Therapy of Ga, LLC
• Infectious Diseases & International Medicine LLC
• Richard L Ingram, MD
• Innovative Dialysis Centers of la Grange, LLC

• All providers in Lagrange, GA
• Medical Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.