Individual provider Active NPI

Reilly Morgan Hyde

  • Physician Assistant
  • Birmingham, AL
National Provider Identifier
1649956970
Registry record updated Feb 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
12151 Issued in GA
Practice address
1716 9TH Ave S
Birmingham, AL 35233-1124
Phone
(205) 975-4237
NPI assigned
Jun 22, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 6, 2024

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
Physician Assistant 363A00000X 12151 GA Primary

Addresses

Primary practice location

1716 9TH Ave S
Birmingham, AL 35233-1124

Mailing address

811 Bear Creek Rd
Moreland, GA 30259-2939
Phone (770) 630-3084

Other practice location 1

1825 Highway 34 E Ste 1200
Newnan, GA 30265-6416
Phone (888) 341-3360

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
I20240221000250 GA Practitioner - Physician Assistant 8729422548 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellstreet of Georgia PCGroup PAC ID 7517126279, 425 clinicians

Practice addresses (Care Compare)

1524 Lafayette Pkwy
Lagrange, GA 30241-2566
Phone (706) 530-2151

1825 Hwy 34 E
Suite 1200
Newnan, GA 30265-6416
Phone (770) 502-2121

1825 Hwy 34 E 1200
Newnan, GA 30265-6416

2292 Peachtree Rd
Atlanta, GA 30309-1147
Phone (404) 382-9941

35 Arbor Springs Ter
Newnan, GA 30265-4214
Phone (470) 323-5200

7990 Wells St
Suite 120
Senoia, GA 30276-2024
Phone (678) 535-0220

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12151GAMDInternal Medicine Physician

Organizations & group practices 1

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": "1687392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707177600000",
    "number": "1649956970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "811 BEAR CREEK RD",
            "city": "MORELAND",
            "state": "GA",
            "postal_code": "302592939",
            "telephone_number": "770-630-3084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1716 9TH AVE S",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352331124",
            "telephone_number": "205-975-4237"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1825 Highway 34 E Ste 1200",
            "address_purpose": "LOCATION",
            "city": "Newnan",
            "state": "GA",
            "postal_code": "302656416",
            "country_code": "US",
            "telephone_number": "888-341-3360",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HYDE",
        "first_name": "REILLY",
        "middle_name": "MORGAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-22",
        "last_updated": "2024-02-06",
        "certification_date": "2024-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "12151",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

Verify at the official NPI Registry.