Individual provider Active NPI

Charmaine L Faucher, PA-C

  • Medical Physician Assistant
  • Marietta, GA
National Provider Identifier
1699785253
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
003932 Issued in GA
Practice address
55 Whitcher Street
Suite 130
Marietta, GA 30060
Phone
(770) 590-1078
Fax
(770) 422-7306
NPI assigned
Aug 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 003932 GA Primary

Addresses

Primary practice location

55 Whitcher Street
Suite 130
Marietta, GA 30060

Mailing address

4798 Deer Run NW
Kennesaw, GA 30152
Phone (770) 794-4423

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
I20060814000067 GA Practitioner - Physician Assistant 4183627110 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Interventional Spine and Pain Management Center PCGroup PAC ID 2769483031, 51 clinicians

Practice addresses (Care Compare)

1388 Wellbrook Necir a
Conyers, GA 30012-3872
Phone (770) 929-9033

Hospital & facility affiliations

  • Wellstar Kennestone Regional Medical Center Hospital, Marietta, GA, CCN 110035
  • Wellstar Windy Hill Hospital Long-term care hospital, Marietta, GA, CCN 112007

Merit-based Incentive Payment System (MIPS)

Final score
83.66 of 100Reported as group
Quality
74.46
Promoting interoperability
99
Improvement activities
40
Cost
71.9

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
003932GAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
The Interventional Spine and Pain Management Center, PC CurrentSince Jul 1, 2016 Accepting new patients
The Interventional Spine and Pain Management Center PC CurrentSince Jul 1, 2016 Accepting new patients
Georgia Spine and Brain, PC Past Accepting new patients

Locations

3390 Peachtree Rd NE
Ste 1500
Atlanta, GA 30326
Phone 40492049502501

15 Medical Dr NE
Ste 301
Cartersville, GA 30121
Phone (770) 590-1078

1388 Wellbrook Cir NE
#A
Conyers, GA 30012
Phone (770) 385-7985

Interoperability endpoints

  • Direct secure messaging: charmaine.faucher@ispm.eclinicaldirectplus.com

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": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1699785253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4798 DEER RUN NW",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "30152",
            "telephone_number": "770-794-4423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 WHITCHER STREET",
            "address_2": "SUITE 130",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "30060",
            "telephone_number": "770-590-1078",
            "fax_number": "770-422-7306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAUCHER",
        "first_name": "CHARMAINE",
        "middle_name": "L",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": "003932",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

Verify at the official NPI Registry.