Marian Leach, PA-C, ATC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

4700 Nelson Brogdon Blvd Ste 250
Buford, GA 30518-5415

Phone

(770) 442-1911

NPI assigned

Sep 6, 2018

Last updated

Jun 27, 2022By 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

Other names 1

• Marian Bornhorst Former name

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

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.

• Southeast Medical Group, P.C.

  dba North Atlanta Primary Care, P.C.

  • Family Medicine Physician
  • Alpharetta, GA
  • NPI 1235296054
  Medicare reassignment
• Choa Hospital Based, LLC

  • Pediatrics Physician
  • Brookhaven, GA
  • NPI 1457695488
  NPD (past)

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

{
    "created_epoch": "1536192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656288000000",
    "number": "1568945400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1090 WESTCROFT LN",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300756020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 NELSON BROGDON BLVD STE 250",
            "city": "BUFORD",
            "state": "GA",
            "postal_code": "305185415",
            "telephone_number": "770-442-1911"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1090 Westcroft Ln",
            "address_purpose": "LOCATION",
            "city": "Roswell",
            "state": "GA",
            "postal_code": "300756020",
            "country_code": "US",
            "telephone_number": "678-956-3034",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEACH",
        "first_name": "MARIAN",
        "credential": "PA-C, ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-06",
        "last_updated": "2022-06-27",
        "certification_date": "2022-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": null,
            "primary": true
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARIAN",
            "last_name": "BORNHORST",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Raequel Larkins Cunningham
• Laurel Baye Healthcare of Lake Lanier, LLC
• Samantha Laurent
• Ashleigh M Lawhorn, BT
• Jennifer Nguyen Le, PA-C
• Bo Ryung Lee, MD
• Joshua Jae Lee, DPM
• Kyongjin Lee, DPT
• Sarah Spring Lee, FNP-C
• Leigh Regine LLC (The Healing Hearts Studio)

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.