Individual provider Active NPI

Zachary Cornett

  • Medical Physician Assistant
  • Atlanta, GA
National Provider Identifier
1760894943
Registry record updated Jan 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
007211 Issued in GA
Practice address
4400 Peachtree Rd NE
Atlanta, GA 30319-2729
Phone
(404) 814-9199
Fax
(404) 869-8118
NPI assigned
May 22, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2024

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 007211 GA Primary
Medical Physician Assistant 363AM0700X

Addresses

Primary practice location

4400 Peachtree Rd NE
Atlanta, GA 30319-2729

Mailing address

4400 Peachtree Rd NE
Atlanta, GA 30319-2729
Phone (404) 814-9199

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
I20141016002718 GA Practitioner - Physician Assistant 2264653138 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellstreet of Georgia PCGroup PAC ID 7517126279, 425 clinicians
Ascend Medical Georgia II PCGroup PAC ID 0547657181, 16 clinicians
Ascend Medical Georgia PCGroup PAC ID 8820488745, 24 clinicians

Practice addresses (Care Compare)

10945 State Bridge Rd
Suite 501
Alpharetta, GA 30022-8163
Phone (404) 996-0194

13682 Hwy 92
Woodstock, GA 30188-4558
Phone (888) 250-5708

1882 Clairmont Rd
Decatur, GA 30033-3420
Phone (888) 250-5708

2292 Peachtree Rd
Atlanta, GA 30309-1147
Phone (404) 382-9941

2505 Dallas Hwy SW
Marietta, GA 30064-2659
Phone (678) 956-6230

2520 N Decatur Rd
Decatur, GA 30033-6117
Phone (678) 685-8100

2701 Holcomb Bridge Rd
Alpharetta, GA 30022-6812
Phone (770) 998-7611

3560 Lenox Rd NE
Suite 1230
Atlanta, GA 30326-4335
Phone (678) 500-8010

4475 W Village Pkwy
Ellenwood, GA 30294-2869
Phone (770) 507-7950

500 Nathan Dean Blvd
Suite 105
Dallas, GA 30157-4911
Phone (470) 624-6793

619 Rankin St NE
Atlanta, GA 30308-2920
Phone (888) 250-5708

882 Ponce de Leon Ave
Atlanta, GA 30306-4268
Phone (770) 809-3034

921 Eagles Landing Pkwy
Stockbridge, GA 30281-5011
Phone (770) 660-5106

Merit-based Incentive Payment System (MIPS)

Final score
91.62 of 100Reported as apm
Quality
83.25
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
007211GAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Wellstreet of Georgia PC CurrentSince Jul 10, 2015 Accepting new patients

Locations

2292 Peachtree Rd NW
Atlanta, GA 30309
Phone (404) 382-9941

Interoperability endpoints

  • Direct secure messaging: zachary.cornett.1@30437.direct.athenahealth.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, 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": "1400716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706054400000",
    "number": "1760894943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4400 PEACHTREE RD NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303192729",
            "telephone_number": "404-814-9199",
            "fax_number": "404-869-8118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4400 PEACHTREE RD NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303192729",
            "telephone_number": "404-814-9199",
            "fax_number": "404-869-8118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORNETT",
        "first_name": "ZACHARY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-22",
        "last_updated": "2024-01-24",
        "certification_date": "2024-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": "007211",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.