Individual provider Active NPI

John Love, PAC

  • Physician Assistant
  • Lawrenceville, GA
National Provider Identifier
1770174658
Registry record updated Apr 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
11945 Issued in GA
Practice address
2200 Medical Center Blvd Ste 350
Lawrenceville, GA 30046-7768
Phone
(678) 312-2700
Fax
(678) 312-2730
NPI assigned
Feb 2, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 11945 GA Primary

Addresses

Primary practice location

2200 Medical Center Blvd Ste 350
Lawrenceville, GA 30046-7768

Mailing address

2200 Medical Center Blvd Ste 350
Lawrenceville, GA 30046-7768
Phone (678) 312-2700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, GA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20241009000482 VA Practitioner - Physician Assistant 3577094986 Reassigns benefits to 1 organization
I20260429001551 GA Practitioner - Physician Assistant 3577094986 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Neurosurgery Associates LLCGroup PAC ID 7012328263, 14 clinicians

Practice addresses (Care Compare)

1000 Medical Ctr Blvd
Lawrenceville, GA 30046-7694
Phone (678) 312-3294

631 Professional Dr
Suite 360
Lawrenceville, GA 30046-3370
Phone (404) 851-8000

Hospital & facility affiliations

  • Northside Hospital Gwinnett Hospital, Lawrenceville, GA, CCN 110087

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11945GAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Neurosurgery Associates LLC Past Accepting new patients

Organizations & group practices 2

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 1

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": "1612224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775001600000",
    "number": "1770174658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 MEDICAL CENTER BLVD STE 350",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300467768",
            "telephone_number": "678-312-2700",
            "fax_number": "678-312-2730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 MEDICAL CENTER BLVD STE 350",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300467768",
            "telephone_number": "678-312-2700",
            "fax_number": "678-312-2730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOVE",
        "first_name": "JOHN",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-02-02",
        "last_updated": "2026-04-01",
        "certification_date": "2026-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "11945",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceville, GA

Sources for this page

Verify at the official NPI Registry.