Sara Lyn Waters, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

005926 Issued in GA

Practice address

1400 River PL
Braselton, GA 30517

Phone

(770) 848-8000

Fax

(770) 219-6021

NPI assigned

Sep 7, 2010

Last updated

Dec 7, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Sara Lyn Nelson Former name

Electronic endpoints 1

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

Mercer University School of Medicine, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northeast Georgia Physicians Group IncGroup PAC ID 6901898386, 884 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northeast Georgia Medical Center, Inc Hospital, Gainesville, GA, CCN 110029
• Northeast Georgia Medical Center Lumpkin Hospital, Dahlonega, GA, CCN 110237

Merit-based Incentive Payment System (MIPS)

Final score

87.83 of 100Reported as group

Quality

80.36

Promoting interoperability

100

Improvement activities

40

Cost

79.08

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: swaters29916@nghs.gadirect.net

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.

• Northeast Georgia Physicians Group Inc

  • Family Medicine Physician
  • Gainesville, GA
  • NPI 1891745212

  Physician Assistant

  Medicare reassignment Care Compare group NPD

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

• NGMC Lumpkin, LLC

  • General Acute Care Hospital
  • Dahlonega, GA
  • NPI 1083174973
  Care Compare affiliation
• Northeast Georgia Medical Center, Inc.

  • General Acute Care Hospital
  • Gainesville, GA
  • NPI 1427055821
  Care Compare affiliation

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

{
    "created_epoch": "1283817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607299200000",
    "number": "1669789061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 742616",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303742616",
            "telephone_number": "770-219-8420",
            "fax_number": "770-219-8440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 RIVER PL",
            "city": "BRASELTON",
            "state": "GA",
            "postal_code": "30517",
            "telephone_number": "770-848-8000",
            "fax_number": "770-219-6021"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 Medical Center Blvd.",
            "address_2": "Kaiser Permanente At Gwinnett Medical Center",
            "address_purpose": "LOCATION",
            "city": "Lawrenceville",
            "state": "GA",
            "postal_code": "30045",
            "country_code": "US",
            "telephone_number": "404-797-9655",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1000 Medical Center Blvd.",
            "address_2": "Kaiser Permanente At Gwinnett Medical Center",
            "address_purpose": "LOCATION",
            "city": "Lawrenceville",
            "state": "GA",
            "postal_code": "30045",
            "country_code": "US",
            "telephone_number": "404-797-9655",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1000 Medical Center Blvd.",
            "address_2": "Kaiser Permanente At Gwinnett Medical Center",
            "address_purpose": "LOCATION",
            "city": "Lawrenceville",
            "state": "GA",
            "postal_code": "30045",
            "country_code": "US",
            "telephone_number": "404-797-9655",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1000 Medical Center Blvd.",
            "address_2": "Kaiser Permanente At Gwinnett Medical Center",
            "address_purpose": "LOCATION",
            "city": "Lawrenceville",
            "state": "GA",
            "postal_code": "30045",
            "country_code": "US",
            "telephone_number": "404-797-9655",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WATERS",
        "first_name": "SARA",
        "middle_name": "LYN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-07",
        "last_updated": "2020-12-07",
        "certification_date": "2020-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": "5926",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": "005926",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "swaters29916@nghs.gadirect.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1400 River Pl",
            "city": "Braselton",
            "state": "GA",
            "country_code": "US",
            "postal_code": "30517",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "SARA",
            "last_name": "NELSON",
            "middle_name": "LYN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Mariana Voronovscaia, AGACNP
• Jeremy Warren Walker, D.O.
• Lance Walker, DC
• Travelyan Marcel Walker, M.D.
• Rachel Warzon, WHNP-BC
• Carmen Waugh, CSA
• Stephanie Weisman, CSFA
• Brandon Hart Wells, DDS
• Wellspect Inc
• Wellstreet of Georgia PC

• Medical Physician Assistant in Braselton, GA
• Providers in Braselton, GA by specialty
• Medical Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2020; 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.