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CARLY ALICIA FUQUA NP-C
NPI 1366260770
Nurse Practitioner in Cumming, GA

Active since October 03, 2024PECOS EnrolledAccepts Medicare Assignment
2000 HOWARD FARM DR STE 450, CUMMING, GA 30041(404) 845-8200 Get Directions Write a Review

NPPES record last updated: October 3, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Carly Alicia Fuqua Np-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CARLY ALICIA FUQUA NP-C (NPI 1366260770) is an individual nurse practitioner in Cumming, Georgia, licensed in Georgia (RN240849) and active in the NPI registry since October 2024. She is enrolled in Medicare PECOS, is affiliated with Northside Hospital Forsyth, and is a graduate of Other (2021).

NPPES Registry Identity

NPI1366260770
Entity TypeIndividualFemale
Primary Taxonomy363L00000X
Provider Legal NameCARLY ALICIA FUQUACredential: NP-C
Location Address2000 HOWARD FARM DR STE 450Cumming, GA 30041-6085
Mailing Address2000 Howard Farm Dr Ste 450Cumming, GA 30041-6085 · (404) 845-8200
Phone(404) 845-8200
Sole ProprietorNo
Medical School CMSOtherGraduated 2021
Enumeration DateOctober 3, 2024
NPPES CertifiedOctober 3, 2024
✔ NPI 1366260770 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
License✔ Licensed in GA · RN240849
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
2000 HOWARD FARM DR STE 450, Cumming, GA 30041
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Carly Alicia Fuqua Np-c is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9335675537
PECOS Enrollment IDI20241211003286
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Carly Fuqua reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Northside Cardiovascular Professional Services, LLC
13 mi
Cardiovascular Disease
1285 UPPER HEMBREE RD
Roswell, GA 30076
  • Reassigned Medicare billing, Georgia enrollment
  • 175 clinicians in this Medicare group
NPI 1518979921 (855) 709-4535

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Northside Hospital Forsyth

Acute Care Hospitals · Cumming, GA
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number110005
Location1200 Northside Forsyth DriveCumming, GA 30041 · Forsyth County
Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30041 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$88.06 typical visit price
range $56.84 – $172.43
Typical copayment $22.01 (range $14.21 – $43.10)
Most-billed visit code 99203
Established Patient
$100.20 typical visit price
range $18.22 – $140.40
Typical copayment $25.05 (range $4.55 – $35.10)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

WILLIAM MARSHALL WILSON NP
Nurse Practitioner (Gerontology)
2000 HOWARD FARM DR STE 450
CUMMING, GA 30041
Forsyth County (404) 962-6000
VIVIENNE YAKUM PAC
Physician Assistant (Surgical)
2000 HOWARD FARM DR STE 450
CUMMING, GA 30041
Forsyth County (404) 962-6000
DR. MICHAEL YAOYAO YIN M.D.
Internal Medicine (Interventional Cardiology)
2000 HOWARD FARM DR STE 450
CUMMING, GA 30041
Forsyth County (901) 489-4991

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Carly Fuqua's NPI number?

The NPI number for Carly Fuqua is 1366260770. It was assigned to this individual provider in the NPPES registry on October 3, 2024.

Where is Carly Fuqua located?

Carly Fuqua practices at 2000 Howard Farm Dr Ste 450, Cumming, GA 30041. The listed phone number is (404) 845-8200.

What is Carly Fuqua's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Carly Fuqua enrolled in Medicare?

Yes. Carly Fuqua is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Carly Fuqua's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Carly Fuqua reassigns Medicare benefits to Northside Cardiovascular Professional Services, LLC (Roswell, GA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Carly Fuqua's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

Is Carly Fuqua affiliated with any hospitals?

According to CMS data, Carly Fuqua is affiliated with Northside Hospital Forsyth.

When was this NPI record last updated?

The NPPES record for Carly Fuqua was last updated on October 3, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.