Individual provider Active NPI

Caroline Ivie, PA-C

  • Medical Physician Assistant
  • Atlanta, GA
National Provider Identifier
1598006892
Registry record updated Jun 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
6744 Issued in GA
Practice address
1400 Tullie Rd NE FL 5
Atlanta, GA 30329-2309
Phone
(404) 785-5437
Fax
(404) 785-4750
NPI assigned
Mar 12, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 6744 GA Primary

Addresses

Primary practice location

1400 Tullie Rd NE FL 5
Atlanta, GA 30329-2309

Mailing address

1400 Tullie Rd NE FL 5
Atlanta, GA 30329-2309
Phone (404) 785-5437

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address choa@choa.gadirect.net

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160608000848 GA Order and Referring Only - Physician Assistant 3375833015

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
006744GAMDOccupational Therapist
6744GAMDMedical Physician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1363046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654473600000",
    "number": "1598006892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 TULLIE RD NE FL 5",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303292309",
            "telephone_number": "404-785-5437",
            "fax_number": "404-785-4750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 TULLIE RD NE FL 5",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303292309",
            "telephone_number": "404-785-5437",
            "fax_number": "404-785-4750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IVIE",
        "first_name": "CAROLINE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-12",
        "last_updated": "2022-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": "6744",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "choa@choa.gadirect.net",
            "affiliation": "N",
            "address_1": "1400 Tullie Rd NE Fl 5",
            "city": "Atlanta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "303292309",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.