Rachael Gabri Peterson, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

11161 Issued in GA

Practice address

1336 Highway 54 W BLDG 200
Fayetteville, GA 30214-4574

Phone

(770) 460-9777

Fax

(770) 460-0650

NPI assigned

Sep 16, 2022

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

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

Physician Assistant

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Georgia Urology, PAGroup PAC ID 8921094376, 99 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northside Hospital Hospital, Atlanta, GA, CCN 110161

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: rachael.peterson.p1@direct.gupa.nextgenshare.com

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.

• Georgia Urology PA

  • Urology Physician
  • Riverdale, GA
  • NPI 1245250646
  Medicare reassignment Care Compare group
• Georgia Urology Piedmont, LLC

  • Urology Physician
  • Conyers, GA
  • NPI 1376163451
  Medicare reassignment
• Georgia Urology PA

  • Urology Physician
  • Woodstock, GA
  • NPI 1316162506
  NPD
• Georgia Urology Piedmont, LLC

  • Urology Physician
  • Fayetteville, GA
  • NPI 1861026619
  NPD
• Georgia Urology, PA

  • Ambulatory Surgical Clinic/Center
  • Braselton, GA
  • NPI 1861222119
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Northside Hospital, Inc.

  dba Northside Hospital

  • General Acute Care Hospital
  • Atlanta, GA
  • NPI 1457396079
  Care Compare affiliation

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

{
    "created_epoch": "1663286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713225600000",
    "number": "1891417788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1930 BRANNAN RD",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302534310",
            "telephone_number": "678-284-4040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1336 HIGHWAY 54 W BLDG 200",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302144574",
            "telephone_number": "770-460-9777",
            "fax_number": "770-460-0650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "RACHAEL",
        "middle_name": "GABRI",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-16",
        "last_updated": "2024-04-16",
        "certification_date": "2024-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "11161",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher Perez, MD
• Laura Sarai Perez, FNP-C
• Ramona Jean Perkins, LPC
• Justice Malee Perry, BA
• Patricia T. Perry, PA
• David Shane Petrie, DDS
• Janine Nicole Pettiford, M.D.
• Shalonda B Pettis, PA-C
• Charles William Pettus, MD
• Brittany Petty

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2024; 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.