Rebecca I Myles, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

7617 Issued in GA

Practice address

5673 Peachtree Dunwoody Rd
Suite 850
Atlanta, GA 30342-1731

Phone

(404) 252-4333

Fax

(404) 252-7000

NPI assigned

Nov 5, 2015

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 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Atlanta Center for Dermatologic Diseases PC

  • Dermatology Physician
  • Roswell, GA
  • NPI 1417910431
  Medicare reassignment

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

{
    "created_epoch": "1446681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446681600000",
    "number": "1801269394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5116 MOUNT VERNON WAY",
            "city": "DUNWOODY",
            "state": "GA",
            "postal_code": "303384212",
            "telephone_number": "678-457-0766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5673 PEACHTREE DUNWOODY RD",
            "address_2": "SUITE 850",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421731",
            "telephone_number": "404-252-4333",
            "fax_number": "404-252-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYLES",
        "first_name": "REBECCA",
        "middle_name": "I",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-05",
        "last_updated": "2015-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "7617",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GEORGIA PA LICENSE",
            "identifier": "7617",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Myidealdoctor LLC
• Myidealdoctor LLC
• Katherine V Mykytka, PHARM.D.
• Lisa Myla, PT
• Kendrick Myles
• Candace L Mynatt, CPNP
• Jhon Kelly Myrtil
• Danielle Nicole Mysore, LCSW
• Mystic Massage
• Mystic Medical, LLC

• Physician Assistant in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2015; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.