Individual provider Active NPI

Kathryn Brianne Fuss, MMS, PA-C

  • Physician Assistant
  • Atlanta, GA
National Provider Identifier
1609213529
Registry record updated Jul 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
11000 Issued in GA
Practice address
371 E Paces Ferry Rd NE Ste 750
Atlanta, GA 30305-2372
Phone
(470) 419-4380
Fax
(470) 298-7737
NPI assigned
Jun 1, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PAC0697 ND
Physician Assistant 363A00000X 11000 GA Primary

Addresses

Primary practice location

371 E Paces Ferry Rd NE Ste 750
Atlanta, GA 30305-2372

Mailing address

2110 Powers Ferry Rd SE Ste 302
Atlanta, GA 30339-5015
Phone (470) 419-4380

Other practice location 1

300 Bullsboro Dr Ste Bc
Newnan, GA 30263-1680
Phone (770) 683-3230

Other practice location 2

550 Eagles Landing Pkwy Ste 204
Stockbridge, GA 30281-9082
Phone (470) 419-4380

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND
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
I20171004002490 ND Practitioner - Physician Assistant 1456593524 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11000GAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Medical Center Fargo CurrentSince Aug 28, 2017 Accepting new patients
Sanford Medical Center Fargo CurrentSince Aug 28, 2017 Accepting new patients
Beltline Bariatric and Surgical Group LLC PastSince Sep 3, 2016 Accepting new patients
Beltline Weight Loss LLC Past Accepting new patients

Locations

801 Broadway N
Fargo, ND 58102
Phone (701) 234-5121

2400 32nd Ave S
Fargo, ND 58103
Phone (701) 234-8800

1220 Sheyenne St
West Fargo, ND 58078
Phone (701) 234-4445

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1370044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658707200000",
    "number": "1609213529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2110 POWERS FERRY RD SE STE 302",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303395015",
            "telephone_number": "470-419-4380",
            "fax_number": "470-298-7737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "371 E PACES FERRY RD NE STE 750",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303052372",
            "telephone_number": "470-419-4380",
            "fax_number": "470-298-7737"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 Bullsboro Dr Ste Bc",
            "address_purpose": "LOCATION",
            "city": "Newnan",
            "state": "GA",
            "postal_code": "302631680",
            "country_code": "US",
            "telephone_number": "770-683-3230",
            "fax_number": "470-298-7737",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "550 Eagles Landing Pkwy Ste 204",
            "address_purpose": "LOCATION",
            "city": "Stockbridge",
            "state": "GA",
            "postal_code": "302819082",
            "country_code": "US",
            "telephone_number": "470-419-4380",
            "fax_number": "470-298-7737",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FUSS",
        "first_name": "KATHRYN",
        "middle_name": "BRIANNE",
        "credential": "MMS, PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-01",
        "last_updated": "2022-07-25",
        "certification_date": "2022-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ND",
            "license": "PAC0697",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "11000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.