Charlsie Thomas Taylor, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

008235 Issued in GA

Practice address

1240 Jesse Jewell Pkwy SE
Suite 500
Gainesville, GA 30501-3862

Phone

(770) 536-9864

Fax

(770) 297-5023

NPI assigned

Jan 9, 2017

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

Other identifiers 1

Other names 1

• Charlsie A Thomas Former name

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, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Northeast Georgia Diagnostic Associates and Clinic, LLCGroup PAC ID 1951655737, 81 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

78.26 of 100Reported as group

Quality

71.9

Promoting interoperability

75

Improvement activities

40

Cost

76.47

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• Direct secure messaging: charlsiethomas@negaidx.allscriptsdirect.net

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.

• Northeast Georgia Diagnostic Associates and Clinic, LLC

  • Multi-Specialty Clinic/Center
  • Gainesville, GA
  • NPI 1144719311
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1483920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606953600000",
    "number": "1962948422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1240 JESSE JEWELL PKWY SE",
            "address_2": "SUITE 500",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013862",
            "telephone_number": "770-536-9864",
            "fax_number": "770-297-5023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1240 JESSE JEWELL PKWY SE",
            "address_2": "SUITE 500",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013862",
            "telephone_number": "770-536-9864",
            "fax_number": "770-297-5023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "CHARLSIE",
        "middle_name": "THOMAS",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-09",
        "last_updated": "2020-12-03",
        "certification_date": "2020-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": "008235",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "008235",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHARLSIE",
            "last_name": "THOMAS",
            "middle_name": "A",
            "credential": "PAC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Julie Suttles Tate, LMSW
• Jeffrey A. Tatro, MD
• Cheryl Denise Tatum
• Mercedes R Tatum, PA
• Alexis Taylor, ND
• Danielle M Taylor, NP
• James Matthew Taylor, MD, MPH
• Jennifer Daughtrey Taylor, SLP
• John Bennett Taylor, D.D.S.
• Jonathan Robert Taylor

• Medical Physician Assistant in Gainesville, GA
• Providers in Gainesville, GA by specialty
• Medical Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2020; 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.