Individual provider Active NPI

Abigael Marie Fenbert, PA

  • Physician Assistant
  • Lawrenceville, GA
National Provider Identifier
1992591812
Registry record updated Jun 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
13152 Issued in GA
Practice address
758 Old Norcross Rd Ste 100
Lawrenceville, GA 30046-3386
Phone
(770) 962-4300
NPI assigned
Apr 17, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 13152 GA Primary

Addresses

Primary practice location

758 Old Norcross Rd Ste 100
Lawrenceville, GA 30046-3386

Mailing address

758 Old Norcross Rd Ste 100
Lawrenceville, GA 30046-3386
Phone (770) 962-4300

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250620003150 GA Practitioner - Physician Assistant 2961914486 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Resurgens, LLCGroup PAC ID 1153224142, 184 clinicians

Practice addresses (Care Compare)

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

758 Old Norcross Rd
Suite 175
Lawrenceville, GA 30046-3386
Phone (678) 985-7190

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
13152GAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Resurgens, LLC CurrentSince Jun 16, 2025 Accepting new patients
Resurgens, LLC CurrentSince Jun 16, 2025 Accepting new patients

Locations

758 Old Norcross Rd
Ste 100
Lawrenceville, GA 30046
Phone (770) 962-4300

5671 Ptree Dunwoody Rd NE
Ste 900
Sandy Springs, GA 30342
Phone (404) 531-8590

5671 Ptree Dunwoody Rd NE
Ste 700
Sandy Springs, GA 30342
Phone (404) 459-3732

Interoperability endpoints

  • Direct secure messaging: abigael.fenbert.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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1744848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749513600000",
    "number": "1992591812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "758 OLD NORCROSS RD STE 100",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300463386",
            "telephone_number": "770-962-4300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "758 OLD NORCROSS RD STE 100",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300463386",
            "telephone_number": "770-962-4300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FENBERT",
        "first_name": "ABIGAEL",
        "middle_name": "MARIE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-17",
        "last_updated": "2025-06-10",
        "certification_date": "2025-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "13152",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceville, GA

Sources for this page

Verify at the official NPI Registry.