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MRS. BRENA JOHNSON SIDDALL PA-C
NPI 1790978526
Physician Assistant in Mc Rae, GA

Active since August 24, 2007PECOS Enrolled
280 E WILLOW CREEK LN, MC RAE, GA 31055(478) 864-3448(478) 864-1288 Get Directions Write a Review

NPPES record last updated: August 20, 2015. Verified against the NPPES registry weekly; last sync: September 06, 2026.

About Mrs. Brena Johnson Siddall Pa-c NPPES

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

MRS. BRENA JOHNSON SIDDALL PA-C (NPI 1790978526) is an individual physician assistant in Mc Rae, Georgia, licensed in Georgia (3400) and active in the NPI registry since August 2007. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1790978526
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameMRS. BRENA JOHNSON SIDDALLCredential: PA-C
Location Address280 E WILLOW CREEK LNMc Rae, GA 31055-5126
Mailing Address2251 W Elm StWrightsville, GA 31096-2017 · (478) 864-3448 · Fax (478) 864-1288
Phone(478) 864-3448
Fax(478) 864-1288
Sole ProprietorNo
Enumeration DateAugust 24, 2007
Last NPPES UpdateAugust 20, 2015
✔ NPI 1790978526 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in GA · 3400
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
280 E WILLOW CREEK LN, Mc Rae, GA 31055
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Other Names 1

Former Name (1)Brena Lagale Johnson Pa-c

Other Identifiers 1

Other003400GA · Georgia License

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mrs. Brena Johnson Siddall Pa-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 31055 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
$83.23 typical visit price
range $53.31 – $164.04
Typical copayment $20.80 (range $13.32 – $41.01)
Most-billed visit code 99203
Established Patient
$66.89 typical visit price
range $16.68 – $133.24
Typical copayment $16.72 (range $4.17 – $33.31)
Most-billed visit code 99213
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 5

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

HEATHER J SPIVEY FNP-C
Nurse Practitioner (Family)
280 E WILLOW CREEK LN
MC RAE, GA 31055
Telfair County (229) 868-0017
LOWER OCONEE COMMUNITY HOSPITAL, INC.
Specialist
280 E WILLOW CREEK LN
MC RAE, GA 31055
Telfair County (229) 868-4122
DR. BRIAN DOUGLAS SIDDALL M.D.
General Practice
280 E WILLOW CREEK LN
MC RAE, GA 31055
Telfair County (478) 864-3448
COMMUNITY HEALTH CARE SYSTEMS, INC
Clinic/Center (Federally Qualified Health Center (FQHC))
280 E WILLOW CREEK LN
MC RAE, GA 31055
Telfair County (478) 864-3448
LOWER OCONEE COMMUNITY HOSPITAL INC
Clinic/Center (Rural Health)
280 E WILLOW CREEK LN
MC RAE, GA 31055
Telfair County (229) 868-4433

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 Brena Siddall's NPI number?

The NPI number for Brena Siddall is 1790978526. It was assigned to this individual provider in the NPPES registry on August 24, 2007. The provider is also known as Brena Lagale Johnson Pa-C.

Where is Brena Siddall located?

Brena Siddall practices at 280 E Willow Creek Ln, Mc Rae, GA 31055. The listed phone number is (478) 864-3448.

What is Brena Siddall's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Brena Siddall enrolled in Medicare?

Yes. Brena Siddall is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Brena Siddall was last updated on August 20, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.