Karen M Brancewicz, PAC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

006063 Issued in GA

Practice address

101 Yorktown
Ste 100
Fayetteville, GA 30214

Phone

(770) 460-4075

Fax

(770) 460-4319

NPI assigned

Feb 9, 2006

Last updated

May 17, 2011By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Privia Pediatric Medical Group of Georgia LLC

  • Pediatrics Physician
  • Fayetteville, GA
  • NPI 1710385513
  NPD

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

{
    "created_epoch": "1139443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1305590400000",
    "number": "1871566885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 10231",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30368",
            "telephone_number": "770-460-4075",
            "fax_number": "770-460-4319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 YORKTOWN",
            "address_2": "STE 100",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "30214",
            "telephone_number": "770-460-4075",
            "fax_number": "770-460-4319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANCEWICZ",
        "first_name": "KAREN",
        "middle_name": "M",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-09",
        "last_updated": "2011-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MA000841L",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "006063",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Quintina Boyd, RBT
• John Brachey, MD
• Teresa Bradley, LPC, NCC, MAC,
• Anthony Joseph Braim, PT, MPT
• Brainthrive
• Sharon Branch, PT
• Brenda James Brannon, L.P.C.
• BRC Medhealth LLC
• Breaking the Chains, Inc
• Jessica Nicole Breaux, NP

• Internal Medicine Physician in Fayetteville, GA
• Providers in Fayetteville, GA by specialty
• Internal Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.