Active NPI
Jamison Louis Hartley, PA-C
- Physician Assistant
- Austell, GA
National Provider Identifier
1508377078
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- Practice address
- 2041 Mesa Valley Way Ste 100
Austell, GA 30106-6828 - Phone
- (770) 944-1100
- NPI assigned
- Oct 23, 2017
- Last updated
- Oct 23, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | Primary |
Addresses
Primary practice location
2041 Mesa Valley Way Ste 100
Austell, GA 30106-6828
Mailing address
2041 Mesa Valley Way Ste 100
Austell, GA 30106-6828
Phone (770) 944-1100
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Resurgens, LLC | Past | Accepting new patients |
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": "1508716800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1508716800000",
"number": "1508377078",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2041 MESA VALLEY WAY STE 100",
"city": "AUSTELL",
"state": "GA",
"postal_code": "301066828",
"telephone_number": "770-944-1100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2041 MESA VALLEY WAY STE 100",
"city": "AUSTELL",
"state": "GA",
"postal_code": "301066828",
"telephone_number": "770-944-1100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARTLEY",
"first_name": "JAMISON",
"middle_name": "LOUIS",
"name_prefix": "Mr.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-10-23",
"last_updated": "2017-10-23",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Austell, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.