Individual provider Active NPI

Brian David Jamail, PA-C

  • Physician Assistant
  • Clayton, GA
National Provider Identifier
1538391776
Registry record updated Jun 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
8827 Issued in GA
Practice address
189 Bo James St Ste 105
Clayton, GA 30525-6199
Phone
(706) 782-0016
Fax
(706) 782-0180
NPI assigned
Aug 21, 2009
Last updated
Jun 5, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU
Physician Assistant 363A00000X 8827 GA Primary

Addresses

Primary practice location

189 Bo James St Ste 105
Clayton, GA 30525-6199

Mailing address

189 Bo James St Ste 105
Clayton, GA 30525-6199
Phone (706) 782-0016

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
I20180919002864 GA Practitioner - Physician Assistant 0941438055 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Nebraska College of Medicine, 2009
Medicare assignment
May accept Medicare assignment
Group practices
Life Point Medical, LLCGroup PAC ID 1850679218, 4 clinicians

Practice addresses (Care Compare)

189 Bo James St
Suite 105
Clayton, GA 30525-6066

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
8827GAMDPhysician Assistant

Interoperability endpoints

  • Direct secure messaging: brian.jamail.1@14758.direct.athenahealth.com

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.

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": "1250812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717545600000",
    "number": "1538391776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "189 BO JAMES ST STE 105",
            "city": "CLAYTON",
            "state": "GA",
            "postal_code": "305256199",
            "telephone_number": "706-782-0016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "189 BO JAMES ST STE 105",
            "city": "CLAYTON",
            "state": "GA",
            "postal_code": "305256199",
            "telephone_number": "706-782-0016",
            "fax_number": "706-782-0180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAMAIL",
        "first_name": "BRIAN",
        "middle_name": "DAVID",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-08-21",
        "last_updated": "2024-06-05",
        "certification_date": "2024-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "8827",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clayton, GA

Sources for this page

Verify at the official NPI Registry.