Individual provider Active NPI

Brian Christopher Evans, PA-C

  • Physician Assistant
  • Kennesaw, GA
National Provider Identifier
1700180254
Registry record updated May 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
6022 Issued in GA
Practice address
270 Chastain Rd NW
Kennesaw, GA 30144-3012
Phone
(770) 421-8005
Fax
(770) 424-5662
NPI assigned
Dec 27, 2010
Last updated
May 3, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2019

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 6022 GA Primary
Surgical Physician Assistant 363AS0400X 006022 GA

Addresses

Primary practice location

270 Chastain Rd NW
Kennesaw, GA 30144-3012

Mailing address

270 Chastain Rd NW
Kennesaw, GA 30144-3012
Phone (770) 421-8005

Other identifiers 1

IdentifierTypeStateIssuer
202I971431OtherGAMEDICARE PTAN

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
I20110128000861 GA Practitioner - Physician Assistant 8123207651 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Emory University School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Resurgens, LLCGroup PAC ID 1153224142, 184 clinicians

Practice addresses (Care Compare)

270 Chastain NWRD
Kennesaw, GA 30144-3012
Phone (770) 421-8005

5671 Peachtree Dunwoody Rd
Suite 900
Atlanta, GA 30342-5022

5671 Peachtree Dunwoody Rd NE
Suite 900 950
Atlanta, GA 30342-5022
Phone (404) 847-9999

Merit-based Incentive Payment System (MIPS)

Final score
93.93 of 100Reported as apm
Quality
82.14
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6022GAMDPhysician Assistant
006022GAMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Resurgens, LLC CurrentSince Apr 29, 2019 Accepting new patients
Pinnacle Orthopaedics & Sports Medicine Specialists LLC CurrentSince Nov 16, 2015 Accepting new patients
Resurgens, LLC CurrentSince Apr 29, 2019 Accepting new patients
Pinnacle Orthopaedics & Sports Medicine Specialists LLC PastSince Nov 17, 2019 Accepting new patients
Northside Surgical Professional Services LLC Past Accepting new patients

Locations

270 Chastain Rd NW
Kennesaw, GA 30144
Phone (678) 594-6080

300 Tower Rd NE
Ste 101
Marietta, GA 30060
Phone (770) 218-0219

300 Tower Rd NE
Ste 200
Marietta, GA 30060
Phone (770) 427-5717

5671 Ptree Dunwoody Rd NE
Ste 700
Sandy Springs, GA 30342
Phone (404) 459-3732

5671 Ptree Dunwoody Rd NE
Ste 900
Sandy Springs, GA 30342
Phone (404) 531-8590

2230 Towne Lake Pkwy
Bldg 300
Woodstock, GA 30189
Phone (770) 517-1900

Interoperability endpoints

  • Direct secure messaging: brian.evans.1@15749.direct.athenahealth.com

Organizations & group practices 5

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": "1293408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556841600000",
    "number": "1700180254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "270 CHASTAIN RD NW",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301443012",
            "telephone_number": "770-421-8005",
            "fax_number": "770-424-5662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "270 CHASTAIN RD NW",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301443012",
            "telephone_number": "770-421-8005",
            "fax_number": "770-424-5662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "BRIAN",
        "middle_name": "CHRISTOPHER",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-12-27",
        "last_updated": "2019-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "6022",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "GA",
            "license": "006022",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "202I971431",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kennesaw, GA

Sources for this page

Verify at the official NPI Registry.