Individual provider Active NPI

William A. Marbury, PAA

  • Anesthesiologist Assistant
  • Atlanta, GA
National Provider Identifier
1689624397
Registry record updated Sep 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiologist AssistantTaxonomy code 367H00000X
License
004644 Issued in GA
Practice address
303 Parkway Dr NE
Atlanta, GA 30312-1212
Phone
(404) 265-4520
Fax
(404) 265-3894
NPI assigned
May 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 004644 GA
Anesthesiologist Assistant 367H00000X 004644 GA Primary

Addresses

Primary practice location

303 Parkway Dr NE
Atlanta, GA 30312-1212

Mailing address

3955 Chimney Ridge CT
Ellenwood, GA 30294-1446
Phone (404) 849-9450

Other identifiers 5

IdentifierTypeStateIssuer
N345536OtherGAWELLCARE
P00301548OtherRAILROAD MEDICARE
782557551BMedicaidGA
782557551CMedicaidGA
782557551AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060518000069 GA Practitioner - Anesthesiology Assistant 9739190257 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology Assistant
Education
Emory University School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emory Specialty Associates, LLCGroup PAC ID 3476559782, 706 clinicians

Practice addresses (Care Compare)

1285 Hembree Rd
Suite 200C
Roswell, GA 30076-4995
Phone (770) 772-5520

Hospital & facility affiliations

  • Emory University Hospital Hospital, Atlanta, GA, CCN 110010

Merit-based Incentive Payment System (MIPS)

Final score
94.51 of 100Reported as apm
Quality
80.61
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Associate of Arts

State licenses

LicenseStateTypeSpecialty
004644GAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
The Emory Clinic Inc CurrentSince Apr 14, 2020 Accepting new patients
Emory Specialty Associates, LLC CurrentSince Jan 22, 2020 Accepting new patients
Mak Anesthesia Holdings LLC CurrentSince Jan 8, 2019 Accepting new patients

Locations

1365 Clifton Rd NE
Atlanta, GA 30322
Phone (404) 778-7525

1821 Clifton Rd NE
Atlanta, GA 30329
Phone (404) 728-6812

303 Parkway Dr NE
Atlanta, GA 30312
Phone (404) 265-4000

3950 Austell Rd
Austell, GA 30106
Phone (770) 732-3752

101 W Ponce de Leon Ave
Decatur, GA 30030
Phone (404) 778-4889

601 S 8th St
Griffin, GA 30224
Phone (770) 228-2721

1285 Hembree Rd
Ste 200C
Roswell, GA 30076
Phone (770) 772-5520

1491 Montreal Rd
Tucker, GA 30084
Phone (770) 270-1284

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 2

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": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599091200000",
    "number": "1689624397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3955 CHIMNEY RIDGE CT",
            "city": "ELLENWOOD",
            "state": "GA",
            "postal_code": "302941446",
            "telephone_number": "404-849-9450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 PARKWAY DR NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303121212",
            "telephone_number": "404-265-4520",
            "fax_number": "404-265-3894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARBURY",
        "first_name": "WILLIAM",
        "middle_name": "A.",
        "credential": "PAA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-11",
        "last_updated": "2020-09-03",
        "certification_date": "2020-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": "004644",
            "primary": false
        },
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "GA",
            "license": "004644",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "N345536",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00301548",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "782557551B",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "782557551C",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "782557551A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.