Active NPI
Rada Pavenko
- Surgical Assistant
- Sugar Hill, GA
National Provider Identifier
1902632037
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Assistant
- License
- 190469
- Practice address
- 424 Eagle Tiff Dr
Sugar Hill, GA 30518-7101 - Phone
- (678) 200-2903
- NPI assigned
- Sep 13, 2024
- Last updated
- Oct 21, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Assistant | 246ZC0007X | 190469 | Primary |
Addresses
Primary practice location
424 Eagle Tiff Dr
Sugar Hill, GA 30518-7101
Mailing address
424 Eagle Tiff Dr
Sugar Hill, GA 30518-7101
Phone (678) 200-2903
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Happy Care | Single Specialty | Current | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1726185600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1729468800000",
"number": "1902632037",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "424 EAGLE TIFF DR",
"city": "SUGAR HILL",
"state": "GA",
"postal_code": "305187101",
"telephone_number": "678-200-2903"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "424 EAGLE TIFF DR",
"city": "SUGAR HILL",
"state": "GA",
"postal_code": "305187101",
"telephone_number": "678-200-2903"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAVENKO",
"first_name": "RADA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-09-13",
"last_updated": "2024-10-21",
"certification_date": "2024-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "246ZC0007X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Specialist/Technologist, Other, Surgical Assistant",
"state": null,
"license": "190469",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sugar Hill, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.