Active NPI
Sydney Hawkins Wyatt, PA-C
- Physician Assistant
- Austell, GA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 10475
- Practice address
- 2041 Mesa Valley Way Ste 100
Austell, GA 30106-6856 - Phone
- (770) 944-1100
- Fax
- (770) 944-6469
- NPI assigned
- Jul 12, 2021
- Last updated
- Jul 26, 2021
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 10475 | GA | Primary |
Addresses
Primary practice location
2041 Mesa Valley Way Ste 100
Austell, GA 30106-6856
Mailing address
2041 Mesa Valley Way Ste 100
Austell, GA 30106-6856
Phone (770) 944-1100
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Mercer University School of Medicine, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2041 Mesa Valley Way
Suite 100
Austell, GA 30106-6856
3698 Largent NW Way
Ste103
Marietta, GA 30064-5923
Phone (678) 354-2883
4441 Atlanta Rd SE
Suite 207
Smyrna, GA 30080-6442
Phone (770) 944-1100
5671 Peachtree Dunwoody Rd
Suite 900
Atlanta, GA 30342-5022
5671 Peachtree Dunwoody Rd NE
Suite 900 950
Atlanta, GA 30342-5022
Phone (404) 847-9999
Merit-based Incentive Payment System (MIPS)
- Final score
- 93.93 of 100
- Quality
- 82.14
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Resurgens, LLC | Current | Accepting new patients | |
| Resurgens, LLC | Past | Accepting new patients |
Locations
2041 Mesa Valley Way
Ste 100
Austell, GA 30106
Phone (770) 944-1100
5671 Ptree Dunwoody Rd NE
Ste 900
Sandy Springs, GA 30342
Phone (404) 531-8590
4441 Atlanta Rd SE
Ste 207
Smyrna, GA 30080
Phone (770) 423-2180
Interoperability endpoints
- sydney.wyatt.1@15749.direct.athenahealth.com
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, 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": "1626048000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1627257600000",
"number": "1962074781",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2041 MESA VALLEY WAY STE 100",
"city": "AUSTELL",
"state": "GA",
"postal_code": "301066856",
"telephone_number": "770-944-1100",
"fax_number": "770-944-6469"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2041 MESA VALLEY WAY STE 100",
"city": "AUSTELL",
"state": "GA",
"postal_code": "301066856",
"telephone_number": "770-944-1100",
"fax_number": "770-944-6469"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WYATT",
"first_name": "SYDNEY",
"middle_name": "HAWKINS",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-07-12",
"last_updated": "2021-07-26",
"certification_date": "2021-07-26",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "GA",
"license": "10475",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Austell, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2021; 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.