Brandy Nichols Owens, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

005435 Issued in GA

Practice address

1514 Vernon Rd
Lagrange, GA 30240

Phone

(706) 880-7222

NPI assigned

Oct 7, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Ms. Brandy Elizabeth Nichols Former name

Electronic endpoints 2

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, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Wellstar Medical Group LLCGroup PAC ID 6709065402, 3,059 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Wellstar West Georgia Medical Center Hospital, Lagrange, GA, CCN 110016

Merit-based Incentive Payment System (MIPS)

Final score

93.93 of 100Reported as apm

Quality

82.14

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bowens402041@directwellstar.org

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.

• Wellstar Medical Group, LLC

  • Family Medicine Physician
  • Kennesaw, GA
  • NPI 1558664003
  Medicare reassignment Care Compare group
• Carrollton Emergency Physicians, PC

  • Emergency Medicine Physician
  • Carrollton, GA
  • NPI 1790724672
  Medicare reassignment
• City of Hope Medical Group of Georgia LLC

  • Internal Medicine Physician
  • Newnan, GA
  • NPI 1447520333
  Medicare reassignment
• Sound Physicians Intensivists of Georgia PC

  • Critical Care Medicine (Internal Medicine) Physician
  • Macon, GA
  • NPI 1376159590

  Physician Assistant

  NPD
• Wellstar Medical Group, LLC

  • Multi-Specialty Clinic/Center
  • Marietta, GA
  • NPI 1275992240
  NPD
• Wellstar Medical Group, LLC

  • Pediatric Anesthesiology Physician
  • Kennesaw, GA
  • NPI 1972905396
  NPD

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

• West Georgia Medical Center, Inc.

  • General Acute Care Hospital
  • Lagrange, GA
  • NPI 1821221144
  Care Compare affiliation

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

{
    "created_epoch": "1223337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624838400000",
    "number": "1619128741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1514 VERNON RD",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302404131",
            "telephone_number": "706-880-7222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1514 VERNON RD",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "30240",
            "telephone_number": "706-880-7222"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "600 Celebrate Life Pkwy",
            "address_purpose": "LOCATION",
            "city": "Newnan",
            "state": "GA",
            "postal_code": "302658001",
            "country_code": "US",
            "telephone_number": "770-400-6000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "705 Dixie St",
            "address_purpose": "LOCATION",
            "city": "Carrollton",
            "state": "GA",
            "postal_code": "301173818",
            "country_code": "US",
            "telephone_number": "770-836-9597",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OWENS",
        "first_name": "BRANDY",
        "middle_name": "NICHOLS",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-07",
        "last_updated": "2021-06-28",
        "certification_date": "2021-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "005435",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "785556519C",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "785556519B",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bowens402041@directwellstar.org",
            "affiliation": "N",
            "address_1": "1514 Vernon Rd",
            "city": "LaGrange",
            "state": "GA",
            "country_code": "US",
            "postal_code": "30240",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ctcasermc@ctcaallscriptsdirect.net",
            "affiliation": "N",
            "address_1": "600 Celebrate Life Pkwy",
            "city": "Newnan",
            "state": "GA",
            "country_code": "US",
            "postal_code": "302658001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "BRANDY",
            "last_name": "NICHOLS",
            "middle_name": "ELIZABETH",
            "prefix": "MS.",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Physician Assistant in Lagrange, GA
• Providers in Lagrange, 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 28, 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.