Individual provider Active NPI

Madison Clawson, RBT

  • Physician Assistant
  • Marietta, GA
National Provider Identifier
1619648458
Registry record updated Jan 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
12797 Issued in GA
Practice address
55 Whitcher St NE Ste 260
Marietta, GA 30060-1169
Phone
(943) 202-7050
Fax
(470) 986-7016
NPI assigned
Sep 22, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X RBT-21-185840 GA
Physician Assistant 363A00000X 12797 GA Primary

Addresses

Primary practice location

55 Whitcher St NE Ste 260
Marietta, GA 30060-1169

Mailing address

55 Whitcher St NE Ste 260
Marietta, GA 30060-1169
Phone (943) 202-7050

Other practice location 1

5000 Business Center Dr Ste 500
Savannah, GA 31405-7423
Phone (912) 295-4956

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
I20250218003755 GA Practitioner - Physician Assistant 3072033299 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
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)

1700 Hospital S Dr
Austell, GA 30106-8159

3747 Roswell Rd
Marietta, GA 30062-6227

3950 Austell Rd
Austell, GA 30106-1121
Phone (770) 732-4022

4550 Cobb Pkwy N NW
Acworth, GA 30101-4182

5150 Stilesboro N W Rd
Suite 220
Kennesaw, GA 30152-7742
Phone (770) 424-8222

55 Whitcher Nest
Marietta, GA 30060-1169
Phone (770) 428-4475

55 Whitcher St
Suite 260
Marietta, GA 30060-1169
Phone (943) 202-7050

625 Church Nest
Marietta, GA 30060-1101
Phone (770) 422-2004

677 Church Nest
Marietta, GA 30060-1101

677 Church St NE
Suite 100P
Marietta, GA 30060-1101
Phone (470) 793-8585

Hospital & facility affiliations

  • Wellstar Cobb Medical Center Hospital, Austell, GA, CCN 110143

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RBT-21-185840GAMDBehavior Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Wellstar Medical Group, LLC CurrentSince Feb 15, 2025 Accepting new patients
Wellstar Medical Group, LLC CurrentSince Feb 15, 2025 Accepting new patients

Locations

5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222

55 Whitcher St NE
Ste 260
Marietta, GA 30060
Phone (770) 423-0395

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": "1632268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737936000000",
    "number": "1619648458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 WHITCHER ST NE STE 260",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300601169",
            "telephone_number": "943-202-7050",
            "fax_number": "470-986-7016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 WHITCHER ST NE STE 260",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300601169",
            "telephone_number": "943-202-7050",
            "fax_number": "470-986-7016"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5000 Business Center Dr Ste 500",
            "address_purpose": "LOCATION",
            "city": "Savannah",
            "state": "GA",
            "postal_code": "314057423",
            "country_code": "US",
            "telephone_number": "912-295-4956",
            "fax_number": "317-520-8200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLAWSON",
        "first_name": "MADISON",
        "credential": "RBT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-22",
        "last_updated": "2025-01-27",
        "certification_date": "2025-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "GA",
            "license": "RBT-21-185840",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "12797",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

Verify at the official NPI Registry.