Individual provider Active NPI

Tracy Paterson, PA-C

  • Medical Physician Assistant
  • Atlanta, GA
National Provider Identifier
1669412623
Registry record updated Jun 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
3967 Issued in GA
Practice address
859 Mount Vernon Hwy NE Ste 300
Atlanta, GA 30328-4255
Phone
(404) 785-0588
Fax
(404) 785-0596
NPI assigned
Jun 7, 2006
Last updated
Jun 6, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 3967 GA Primary

Addresses

Primary practice location

859 Mount Vernon Hwy NE Ste 300
Atlanta, GA 30328-4255

Mailing address

859 Mount Vernon Hwy NE Ste 300
Atlanta, GA 30328-4255
Phone (404) 785-0588

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address choa@choa.gadirect.net

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
I20250315000163 GA Order and Referring Only - Physician Assistant 6709308083

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Choa Multispecialty, LLC PastSince Sep 25, 2019 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654473600000",
    "number": "1669412623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "859 MOUNT VERNON HWY NE STE 300",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303284255",
            "telephone_number": "404-785-0588",
            "fax_number": "404-785-0596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "859 MOUNT VERNON HWY NE STE 300",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303284255",
            "telephone_number": "404-785-0588",
            "fax_number": "404-785-0596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATERSON",
        "first_name": "TRACY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-07",
        "last_updated": "2022-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": "3967",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "choa@choa.gadirect.net",
            "affiliation": "N",
            "address_1": "859 Mount Vernon Hwy NE Ste 300",
            "city": "Atlanta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "303284255",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.