Carly Elsie Threlkeld, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

10609 Issued in GA

Practice address

1515 River PL Ste 280
Braselton, GA 30517-5603

Phone

(770) 848-6190

NPI assigned

Jun 2, 2020

Last updated

Oct 1, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

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

Specialty

Physician Assistant

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Georgialina Physical Therapy Associates LLCGroup PAC ID 6002812401, 406 clinicians

Northeast Georgia Physicians Group IncGroup PAC ID 6901898386, 884 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northeast Georgia Medical Center, Inc Hospital, Gainesville, GA, CCN 110029
• NGMC Barrow, LLC Hospital, Winder, GA, CCN 110045

Merit-based Incentive Payment System (MIPS)

Final score

87.83 of 100Reported as group

Quality

80.36

Promoting interoperability

100

Improvement activities

40

Cost

79.08

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Northeast Georgia Physicians Group Inc

  • Family Medicine Physician
  • Gainesville, GA
  • NPI 1891745212

  Physician Assistant

  Medicare reassignment Care Compare group NPD
• Georgialina Physical Therapy Associates LLC

  dba Athletico Physical Therapy

  • Physical Therapist
  • Augusta, GA
  • NPI 1679286934
  Care Compare group
• The Longstreet Clinic PC

  • Prosthetic/Orthotic Supplier
  • Gainesville, GA
  • NPI 1053422428
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• NGMC Barrow LLC

  dba NGMC Barrow

  • General Acute Care Hospital
  • Winder, GA
  • NPI 1881144889
  Care Compare affiliation
• Northeast Georgia Medical Center, Inc.

  • General Acute Care Hospital
  • Gainesville, GA
  • NPI 1427055821
  Care Compare affiliation

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

{
    "created_epoch": "1591056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633046400000",
    "number": "1548884893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 742616",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303742616",
            "telephone_number": "770-219-8420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 RIVER PL STE 280",
            "city": "BRASELTON",
            "state": "GA",
            "postal_code": "305175603",
            "telephone_number": "770-848-6190"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1404 River Pl",
            "address_purpose": "LOCATION",
            "city": "Braselton",
            "state": "GA",
            "postal_code": "305175600",
            "country_code": "US",
            "telephone_number": "770-848-6190",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "517 Fambrough Dr",
            "address_purpose": "LOCATION",
            "city": "Elberton",
            "state": "GA",
            "postal_code": "306356627",
            "country_code": "US",
            "telephone_number": "706-498-6572",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THRELKELD",
        "first_name": "CARLY",
        "middle_name": "ELSIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-02",
        "last_updated": "2021-10-01",
        "certification_date": "2021-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "10609",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "GA",
            "license": "10609",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cthrelkeld120982@nghs.gadirect.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1515 River Pl Ste 280",
            "city": "Braselton",
            "state": "GA",
            "country_code": "US",
            "postal_code": "305175603",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Rana Zouveenoor Tariq, M.D
• Uday K Tata, M.D.
• Mulualem Yigzaw Teferi, M.D.
• James Stephen Templeton, LDO
• The Ora House
• Total Renal Care Inc (Braselton Dialysis)
• Tuan Truong, MD
• Margaret Trupiano, NP
• Braxton Turner
• Gursimran Nanki Udhwani, DO

• Surgical Physician Assistant in Braselton, GA
• Providers in Braselton, GA by specialty
• Surgical Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2021; 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.