Individual provider Active NPI

Brittany Tara Fox, PA-C

  • Physician Assistant
  • Hiram, GA
National Provider Identifier
1598100232
Registry record updated Jan 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
06780 Issued in GA
Practice address
76 Highland Pavilion CT
Suite 133
Hiram, GA 30141-3169
Phone
(770) 439-1172
Fax
(706) 378-1204
NPI assigned
May 8, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 06780 GA Primary

Addresses

Primary practice location

76 Highland Pavilion CT
Suite 133
Hiram, GA 30141-3169

Mailing address

PO Box 80883
Athens, GA 30608-0883
Phone (706) 549-8114

Other identifiers 1

IdentifierTypeStateIssuer
003136750EMedicaidGA

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
I20131028000985 GA Practitioner - Physician Assistant 3274768312 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Interventional Spine and Pain Management Center PCGroup PAC ID 2769483031, 51 clinicians

Practice addresses (Care Compare)

1388 Wellbrook Necir a
Conyers, GA 30012-3872
Phone (770) 929-9033

812 S Park St
Carrollton, GA 30117-4412
Phone (770) 929-9033

Hospital & facility affiliations

  • Tanner Medical Center - Carrollton Hospital, Carrollton, GA, CCN 110011

Merit-based Incentive Payment System (MIPS)

Final score
83.66 of 100Reported as group
Quality
74.46
Promoting interoperability
99
Improvement activities
40
Cost
71.9

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
06780GAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
The Interventional Spine and Pain Management Center, PC CurrentSince Sep 3, 2017 Accepting new patients
CPM Labs, LLC Current Accepting new patients
The Interventional Spine and Pain Management Center PC CurrentSince Sep 3, 2017 Accepting new patients

Locations

3390 Peachtree Rd NE
Ste 1500
Atlanta, GA 30326
Phone 40492049502501

1388 Wellbrook Cir NE
#A
Conyers, GA 30012
Phone (770) 385-7985

Interoperability endpoints

  • Direct secure messaging: brittany.fox@ispm.eclinicaldirectplus.com

Organizations & group practices 3

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.

Hospital & facility affiliations 1

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": "1367971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422403200000",
    "number": "1598100232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 80883",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306080883",
            "telephone_number": "706-549-8114",
            "fax_number": "706-549-7558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "76 HIGHLAND PAVILION CT",
            "address_2": "SUITE 133",
            "city": "HIRAM",
            "state": "GA",
            "postal_code": "301413169",
            "telephone_number": "770-439-1172",
            "fax_number": "706-378-1204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOX",
        "first_name": "BRITTANY",
        "middle_name": "TARA",
        "name_prefix": "Miss",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-08",
        "last_updated": "2015-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "06780",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003136750E",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hiram, GA

Sources for this page

Verify at the official NPI Registry.