Brook Lynn Ross, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

12578 Issued in GA

Practice address

1240 Eagles Landing Pkwy Ste 110
Stockbridge, GA 30281-5173

Phone

(770) 389-3855

NPI assigned

Jan 27, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Brook Lynn Roddenberry Former name

Medicare fee-for-service enrollment

Enrolled in NC, GA2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Aylo Health, LLCGroup PAC ID 8022901925, 112 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Aylo Health, LLC

  • Family Medicine Physician
  • Atlanta, GA
  • NPI 1013018811
  Medicare reassignment Care Compare group NPD
• Blue Ridge Community Health Services Inc

  dba Blue Ridge Health-Highlands Cashiers

  • Federally Qualified Health Center (FQHC)
  • Highlands, NC
  • NPI 1437725041
  Medicare reassignment NPD
• Blue Ridge Community Health Services Inc.

  dba Blue Ridge Health-Givens Gerber

  • Federally Qualified Health Center (FQHC)
  • Asheville, NC
  • NPI 1679137558
  Medicare reassignment NPD
• Blue Ridge Community Health Services, Inc

  dba Haywood Health Center

  • Federally Qualified Health Center (FQHC)
  • Clyde, NC
  • NPI 1407200264
  Medicare reassignment NPD
• Blue Ridge Community Health Services, Inc

  dba 7th Avenue Health Center

  • Federally Qualified Health Center (FQHC)
  • Hendersonville, NC
  • NPI 1801261391
  Medicare reassignment NPD
• Blue Ridge Community Health Services, Inc

  dba Sylva Health Center

  • Federally Qualified Health Center (FQHC)
  • Sylva, NC
  • NPI 1881130540
  Medicare reassignment NPD
• Blue Ridge Community Health Services, Inc.

  dba Blue Ridge Health-Swain

  • Federally Qualified Health Center (FQHC)
  • Bryson City, NC
  • NPI 1124668868
  Medicare reassignment NPD
• Blue Ridge Community Health Services, Inc.

  dba Hendersonville Family Health Center

  • Federally Qualified Health Center (FQHC)
  • Hendersonville, NC
  • NPI 1437593787
  Medicare reassignment NPD
• Blue Ridge Community Health Services, Inc.

  dba Polk Health Center

  • Federally Qualified Health Center (FQHC)
  • Columbus, NC
  • NPI 1750757803
  Medicare reassignment NPD
• Blue Ridge Community Health Services, Inc.

  dba Blue Ridge Community Health Services

  • Federally Qualified Health Center (FQHC)
  • Hendersonville, NC
  • NPI 1225029051
  Medicare reassignment
• Aylo Health, LLC

  • Diagnostic Radiology Physician
  • Locust Grove, GA
  • NPI 1194433219
  NPD
• Blue Ridge Community Health Services Inc

  dba Brevard Health Center

  • Federally Qualified Health Center (FQHC)
  • Brevard, NC
  • NPI 1750144119
  NPD

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

{
    "created_epoch": "1643241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728864000000",
    "number": "1538812805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 RIVERWOOD PKWY SE STE 250",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303393304",
            "telephone_number": "770-914-0116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1240 EAGLES LANDING PKWY STE 110",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302815173",
            "telephone_number": "770-389-3855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSS",
        "first_name": "BROOK",
        "middle_name": "LYNN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-27",
        "last_updated": "2024-10-14",
        "certification_date": "2024-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-13447",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9115415",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "12578",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BROOK",
            "last_name": "RODDENBERRY",
            "middle_name": "LYNN",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Yaasmyn Rogers
• Iecher Hall Rooks, RN
• William Devon Roots, (CSFA0 (CST)
• Nicole Lawrence Rosbeck, CN0030085465
• Steven Michael Rosenthal, MD
• Cicely A Ross, NP
• Donna Lynn Ross, RN, CCM
• Lela C Rowe
• Morgan Rowser
• Jauna D Royal, NP-C

• Physician Assistant in Stockbridge, GA
• Providers in Stockbridge, GA by specialty
• Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2024; 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.