Wendy Anita Royal, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

004813 Issued in GA

Practice address

4919 Atlanta Hwy
Flowery Branch, GA 30542-3328

Phone

(770) 965-9222

Fax

(770) 965-8811

NPI assigned

Jul 28, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 12

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• Northeast Georgia Medical Center, Inc.

  • General Acute Care Hospital
  • Gainesville, GA
  • NPI 1427055821
  NPD (past)

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1266537600000",
    "number": "1740294560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 S ENOTA DR NE",
            "address_2": "STE Q",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305012400",
            "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": "4919 ATLANTA HWY",
            "city": "FLOWERY BRANCH",
            "state": "GA",
            "postal_code": "305423328",
            "telephone_number": "770-965-9222",
            "fax_number": "770-965-8811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROYAL",
        "first_name": "WENDY",
        "middle_name": "ANITA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-28",
        "last_updated": "2010-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "004813",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "748980904G",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "10058150",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "343820",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "341310",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000311737C",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "343819",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "748980904B",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PIN QC",
            "identifier": "511I970299",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "748980904A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000311737D",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000311737E",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "343821",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sydney Hope Rosemore
• Trinity Ross
• Jessica Laine Rowe, MSN, APRN, FNP-C
• Royal E Fink DDS PC
• Royal Lakes Family and Cosmetic Dentistry, LLC
• Sonea Maria Russell, PTA
• Amanda Renee Salerno
• Samuel S Kwon - Flowery Branch DMD PC
• Anna Satterfield, M.S., OTR/L
• Justin Asling Sawyer, COTA

• Physician Assistant in Flowery Branch, GA
• Providers in Flowery Branch, GA by specialty
• Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.