Individual provider Active NPI

Sylvonne Kenyatta Cox, PA-C

  • Medical Physician Assistant
  • Austell, GA
National Provider Identifier
1992863385
Registry record updated Aug 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
4564 Issued in GA
Practice address
1664 Mulkey Rd
Austell, GA 30106-1114
Phone
(770) 422-1372
NPI assigned
Dec 5, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 27, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 4564 GA Primary

Addresses

Primary practice location

1664 Mulkey Rd
Austell, GA 30106-1114

Mailing address

1664 Mulkey Rd
Austell, GA 30106-1114
Phone (770) 422-1372

Other practice location 1

411 Stephenson Avenue
Savannah, GA 31405-5968
Phone (912) 354-7679

Other identifiers 2

IdentifierTypeStateIssuer
400763209AMedicaidGA
400763209BMedicaidGA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address scox376516@directwellstar.org

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
I20200710001510 GA Practitioner - Physician Assistant 7214232099 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Wellstar Medical Group LLCGroup PAC ID 6709065402, 3,059 clinicians

Practice addresses (Care Compare)

1664 Mulkey Rd
Austell, GA 30106-1114
Phone (770) 422-1372

400 Tower Rd NE
Suite 200
Marietta, GA 30060-9412
Phone (770) 422-1372

5150 Stilesboro N W Rd
Suite 220
Kennesaw, GA 30152-7742
Phone (770) 424-8222

Merit-based Incentive Payment System (MIPS)

Final score
93.93 of 100Reported as apm
Quality
82.14
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4564GAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Wellstar Medical Group, LLC CurrentSince Jul 1, 2020 Accepting new patients
Wellstar Medical Group, LLC CurrentSince Jul 1, 2020 Accepting new patients
Coastal Medical Specialists in Lung & Critical Care, PC Past Accepting new patients

Locations

1664 Mulkey Rd
Austell, GA 30106
Phone (770) 941-7709

5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222

805 Sandy Plains Rd
Marietta, GA 30066
Phone (770) 792-1616

Interoperability endpoints

  • Direct secure messaging: scox376516@directwellstar.org

Organizations & group practices 4

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": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598486400000",
    "number": "1992863385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1664 MULKEY RD",
            "city": "AUSTELL",
            "state": "GA",
            "postal_code": "301061114",
            "telephone_number": "770-422-1372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1664 MULKEY RD",
            "city": "AUSTELL",
            "state": "GA",
            "postal_code": "301061114",
            "telephone_number": "770-422-1372"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "411 Stephenson Avenue",
            "address_purpose": "LOCATION",
            "city": "Savannah",
            "state": "GA",
            "postal_code": "314055968",
            "country_code": "US",
            "telephone_number": "912-354-7679",
            "fax_number": "912-354-4018",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COX",
        "first_name": "SYLVONNE",
        "middle_name": "KENYATTA",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-05",
        "last_updated": "2020-08-27",
        "certification_date": "2020-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": "4564",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "400763209A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "400763209B",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "scox376516@directwellstar.org",
            "affiliation": "N",
            "address_1": "1664 Mulkey Rd",
            "city": "Austell",
            "state": "GA",
            "country_code": "US",
            "postal_code": "301061114",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Austell, GA

Sources for this page

Verify at the official NPI Registry.