Trevor Frederick Ezzell, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN152048 Issued in GA

Practice address

655 Jesse Jewell Pkwy SE
Ste B
Gainesville, GA 30501-3854

Phone

(770) 532-7092

Fax

(770) 536-0383

NPI assigned

Jul 10, 2008

Sex

Male

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 6

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

Specialty

Nurse Practitioner

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Advanced Joint Surgery Specialists, LLCGroup PAC ID 2961795190, 46 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

79.29 of 100Reported as group

Quality

67.84

Promoting interoperability

73

Improvement activities

40

Cost

85.62

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: trevor.ezzell@longstreetclinic.gadirect.net

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.

• Advanced Joint Surgery Specialists, LLC

  • Orthopaedic Surgery Physician
  • Atlanta, GA
  • NPI 1477929206
  Medicare reassignment Care Compare group NPD
• Northeast Georgia Orthopaedics & Sports Medicine, LLC

  • Orthopaedic Surgery Physician
  • Hoschton, GA
  • NPI 1093725327
  NPD (past)
• Northeast Georgia Orthopaedics & Sports Medicine, LLC

  • Orthopaedic Surgery Physician
  • Gainesville, GA
  • NPI 1427079185
  NPD (past)
• Northside Surgical Professional Services LLC

  • Surgery Physician
  • Atlanta, GA
  • NPI 1356630990
  NPD (past)

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

{
    "created_epoch": "1215648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329696000000",
    "number": "1780847699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 658",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305030658",
            "telephone_number": "770-718-1122",
            "fax_number": "770-535-7445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 JESSE JEWELL PKWY SE",
            "address_2": "STE B",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013854",
            "telephone_number": "770-532-7092",
            "fax_number": "770-536-0383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EZZELL",
        "first_name": "TREVOR",
        "middle_name": "FREDERICK",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-10",
        "last_updated": "2012-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN152048",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "462656",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "01228809",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "129681407A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00903614",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "129681407B",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "129681407C",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Expert Wound Care LLC
• Eye Site of Gainesville, Inc.
• Eyecare Associates, P.C.
• Nicholas William Eyrich, MD, MS
• Damian Onyedikachi Ezuma, MD
• David Faircloth
• Faith Medical Services (Julie Martin)
• Roohi Faiyaz, MD
• Fardeen Ahmed Faiz, M.D
• Family First Vision Care Georgia

• Family Nurse Practitioner in Gainesville, GA
• Providers in Gainesville, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.