Individual provider Active NPI

Jonathan Lee Nix, PA

  • Surgical Physician Assistant
  • Athens, GA
National Provider Identifier
1811087299
Registry record updated Feb 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
003568 Issued in GA
Practice address
1500 Oglethorpe Ave
Suite 300a
Athens, GA 30606-2179
Phone
(706) 543-5858
Fax
(706) 543-2050
NPI assigned
Oct 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2009

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 003568 GA
Surgical Physician Assistant 363AS0400X 003568 GA Primary

Addresses

Primary practice location

1500 Oglethorpe Ave
Suite 300a
Athens, GA 30606-2179

Mailing address

1500 Oglethorpe Ave
Suite 300a
Athens, GA 30606-2179
Phone (706) 543-5858

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
I20060112000026 GA Practitioner - Physician Assistant 4981627395 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Metroderm, P.C.Group PAC ID 8729076443, 33 clinicians

Practice addresses (Care Compare)

225 Adams Dr
Demorest, GA 30535-4577
Phone (770) 536-7546

875 Johnson Ferry Rd
Atlanta, GA 30342-1418

875 Johnson Ferry Rd NE
Suite 001
Atlanta, GA 30342-1418
Phone (404) 257-9933

974 S Enota Dr NE
Gainesville, GA 30501-2429
Phone (770) 536-7546

Hospital & facility affiliations

  • Northeast Georgia Medical Center, Inc Hospital, Gainesville, GA, CCN 110029

Merit-based Incentive Payment System (MIPS)

Final score
93.93 of 100Reported as apm
Quality
82.14
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
003568GAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Metroderm, P.C. CurrentSince Nov 1, 2022 Accepting new patients
The Longstreet Clinic PC Past Accepting new patients

Locations

974 S Enota Dr NE
Gainesville, GA 30501
Phone (770) 536-7546

875 Johnson Fy Rd NE
Ste 300
Sandy Springs, GA 30342
Phone (404) 257-9933

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": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1235347200000",
    "number": "1811087299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 OGLETHORPE AVE",
            "address_2": "SUITE 300A",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306062179",
            "telephone_number": "706-543-5858",
            "fax_number": "706-543-2050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 OGLETHORPE AVE",
            "address_2": "SUITE 300A",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306062179",
            "telephone_number": "706-543-5858",
            "fax_number": "706-543-2050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIX",
        "first_name": "JONATHAN",
        "middle_name": "LEE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-13",
        "last_updated": "2009-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": "003568",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "GA",
            "license": "003568",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Athens, GA

Sources for this page

Verify at the official NPI Registry.