MADISON REED WHORTON PA-C
NPI 1336682319
Physician Assistant in Taylorsville, GA
NPI Status: Active since November 23, 2016
Contact Information
48 HILLS CREEK RD
TAYLORSVILLE, GA
ZIP 30178
Phone: (770) 684-8700
Fax: (770) 684-4603
- Individual
- Female
- Years of Experience 10
- Physician Assistant
- Accepts Insurance
- Accepts Medicare Approved Payment
- PECOS Enrolled
- Medicare Quality Reporting
About MADISON WHORTON
This page provides the complete NPI Profile along with additional information for Madison Whorton, a primary care provider established in Taylorsville, Georgia with a medical specialization in Physician Assistant and more than 10 years of experience. She graduated from Lincoln Memorial University Medical Department in 2016. The healthcare provider is registered in the NPI registry with number 1336682319 assigned on November 2016. The practitioner's primary taxonomy code is 363A00000X with license number 008207 (GA). The provider is registered as an individual and her NPI record was last updated 4 years ago.
- NPI
- 1336682319
- Provider Name
- MADISON REED WHORTON PA-C
- Other Name
- MADISON REED
- Other Name Type
- Other Name (5)
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 48 HILLS CREEK RD TAYLORSVILLE, GA 30178
- Location Phone
- (770) 684-8700
- Location Fax
- (770) 684-4603
- Mailing Address
- 420 E 2ND AVE STE 103 ROME, GA 30161
- Mailing Phone
- (706) 509-3000
- Medical School Name
- LINCOLN MEMORIAL UNIVERSITY MEDICAL DEPARTMENT
- Graduation Year
- 2016
- Is Sole Proprietor?
- No
- Enumeration Date
- 11-23-2016
- Last Update Date
- 06-04-2021
- Code Navigator
A primary care provider (PCP) like Madison Whorton sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Physician Assistant
- Taxonomy Code
- 363A00000X
- Type
- Physician Assistants & Advanced Practice Nursing Providers
- License No.
- 008207
- License State
- GA
- Taxonomy Description
- 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.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- SoloCare Bronze EPO HDHP 8050 10004 - EPO
- SoloCare Exp Bronze EPO 7200 - $0 Generic Rx 10015 - EPO
- SoloCare Gold EPO 2300 - 3 Free PCP Visits, $5 Generic Rx 10010 - EPO
- SoloCare Silver EPO 6000/60 - 3 Free PCP Visits 10014 - EPO
- SoloCare Silver EPO 7000 - 3 Free PCP Visits, $5 Generic Rx 10013 - EPO
- SoloCare Standard Exp Bronze EPO 10008 - EPO
- SoloCare Standard Gold EPO 10006 - EPO
- SoloCare Standard Platinum EPO 10005 - EPO
- SoloCare Standard Silver EPO 10007 - EPO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Medicare Participation & PECOS Enrollment Status
Madison Whorton is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.
Madison Whorton is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
PECOS PAC ID: 9133409162
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.PECOS Enrollment ID: I20161209000803
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.Accepts Medicare Assignment? Yes
What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Areas of Expertise
The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.
Automated urinalysis test
Established patient office or other outpatient visit, 20-29 minutes
Established patient office or other outpatient visit, 30-39 minutes
Injection of drug or substance under skin or into muscle
Injection, dexamethasone sodium phosphate, 1 mg
Insertion of needle into vein for collection of blood sample
An automated urinalysis test is a routine examination that checks your urine for various substances. It can help identify potential health issues such as kidney problems or diabetes. The test uses a machine to analyze a small urine sample, providing quick and accurate results.
This service was performed 29 times for 23 patientsThis is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
This service was performed 169 times for 106 patientsThis is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
This service was performed 101 times for 74 patientsThis procedure involves administering medication directly under the skin or into a muscle. A small needle is used to inject the drug, allowing it to be absorbed quickly into the bloodstream. It's a common method for delivering a variety of medications.
This service was performed 21 times for 19 patientsDexamethasone sodium phosphate is a medication given via injection. It is a type of steroid that helps reduce inflammation and immune responses. It can be used to treat a variety of conditions, such as allergies, skin conditions, arthritis, and more.
This service was performed 72 times for 11 patientsThis procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.
This service was performed 153 times for 81 patientsPhysician Visit Costs
The typical physician office visit costs for Medicare beneficiaries in this area are: $20.8 for a new patient copayment and $16.72 for an established patient copayment.
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 30178 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $83.23
- Minimum New Patient Price $53.31
- Maximum New Patient Price $164.04
- Average New Patient Copayment $20.8
- Minimum New Patient Copayment $13.32
- Maximum New Patient Copayment $41.01
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99213
- Average Established Patient Price $66.89
- Minimum Established Patient Price $16.68
- Maximum Established Patient Price $133.24
- Average Established Patient Copayment $16.72
- Minimum Established Patient Copayment $4.17
- Maximum Established Patient Copayment $33.31
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
Quality Reporting
The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.
| Quality Measure | Performance | Number of Patients |
|---|---|---|
| Breast Cancer Screening | 45% | 75 |
| Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer | ||
| Chronic Care and Preventative Care Management for Empaneled Patients | Yes | N/A |
| Proactively manage chronic and preventive care for empaneled patients that could include one or more of the following: • Provide patients annually with an opportunity for development and/or adjustment of an individualized plan of care as appropriate to age and health status, including health risk appraisal; gender, age and condition-specific preventive care services; and plan of care for chronic conditions; • Use condition-specific pathways for care of chronic conditions (e.g., hypertension, diabetes, depression, asthma and heart failure) with evidence-based protocols to guide treatment to target; such as a CDC-recognized diabetes prevention program; • Use pre-visit planning to optimize preventive care and team management of patients with chronic conditions; • Use panel support tools (registry functionality) to identify services due; • Use predictive analytical models to predict risk, onset and progression of chronic diseases; or • Use reminders and outreach (e.g., phone calls, emails, postcards, patient portals and community health workers where available) to alert and educate patients about services due; and/or routine medication reconciliation. | ||
| Colorectal Cancer Screening | 64% | 117 |
| Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer | ||
| Diabetes: Eye Exam | 28% | 50 |
| Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period | ||
| Documentation of Current Medications in the Medical Record | 100% | 427 |
| Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter. This list must include ALL known prescriptions, over-the-counters, herbals, and vitamin/mineral/dietary (nutritional) supplements AND must contain the medications' name, dosage, frequency and route of administration | ||
| e-Prescribing | 98% | 4293 |
| At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology. | ||
| Health Information Exchange | 63% | 137 |
| The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for at least one transition of care or referral. | ||
| Immunization Registry Reporting | Yes | N/A |
| The MIPS eligible clinician is in active engagement with a public health agency to submit immunization data. | ||
| Implementation of medication management practice improvements | Yes | N/A |
| Manage medications to maximize efficiency, effectiveness and safety that could include one or more of the following: Reconcile and coordinate medications and provide medication management across transitions of care settings and eligible clinicians or groups; Integrate a pharmacist into the care team; and/or Conduct periodic, structured medication reviews. | ||
| Measurement and Improvement at the Practice and Panel Level | Yes | N/A |
| Measure and improve quality at the practice and panel level, such as the American Board of Orthopaedic Surgery (ABOS) Physician Scorecards, that could include one or more of the following: • Regularly review measures of quality, utilization, patient satisfaction and other measures that may be useful at the practice level and at the level of the care team or MIPS eligible clinician or group (panel); and/or • Use relevant data sources to create benchmarks and goals for performance at the practice level and panel level. | ||
| Medication Reconciliation | 100% | 65 |
| The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician. | ||
| Patient-Specific Education | 61% | 293 |
| The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician. | ||
| Preventive Care and Screening: Screening for Depression and Follow-Up Plan | 38% | 164 |
| Percentage of patients aged 12 years and older screened for depression on the date of the encounter using an age appropriate standardized depression screening tool AND if positive, a follow-up plan is documented on the date of the positive screen | ||
| Provide Patient Access | 100% | 293 |
| At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold certain information. | ||
| Secure Messaging | 20% | 293 |
| For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure message sent by the patient (or the patient-authorized representative) during the performance period. | ||
| Security Risk Analysis | Yes | N/A |
| Conduct or review a security risk analysis in accordance with the requirements in 45 CFR 164.308(a)(1), including addressing the security (to include encryption) of ePHI data created or maintained by certified EHR technology in accordance with requirements in 45 CFR164.312(a)(2)(iv) and 45 CFR 164.306(d)(3), and implement security updates as necessary and correct identified security deficiencies as part of the MIPS eligible clinician's risk management process. | ||
| Specialized Registry Reporting | Yes | N/A |
| The MIPS eligible clinician is in active engagement to submit data to specialized registry. To earn a 5 % bonus in the promoting interoperability performance category score for submitting to one or more public health or clinical data registries also attest to PI_TRANS_PHCDRR_3_MULTI. | ||
| Use of decision support and standardized treatment protocols | Yes | N/A |
| Use decision support and standardized treatment protocols to manage workflow in the team to meet patient needs. | ||
Find Provider Hospital Affiliations - Privileges
Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.
Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Madison Whorton is affiliated with the following medical facilities:
| Hospital Name | Address | Phone | Hospital Type | Overall Rating |
|---|---|---|---|---|
| ATRIUM HEALTH FLOYD MEDICAL CENTER | 304 TURNER MCCALL BOULEVARD ROME, GA 30162 | (706) 509-6900 | Acute Care Hospitals |
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 3 | 3 | 6 | 6 | 8 | 2 | 3 | 1 | 9 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 3 | 6 | 6 | 12 | 8 | 4 | 3 | 2 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 3 + 6 + 6 + 1 + 2 + 8 + 4 + 3 + 2 + 24 = 61 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 61 = 9 | 9 | ||||||||
The NPI number 1336682319 is valid because the calculated check digit 9 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 4 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1932121282 | ANN P WARD M.D. Individual | Internal Medicine (Endocrinology, Diabetes & Metabolism) | 48 HILLS CREEK RD TAYLORSVILLE, GA 30178 (770) 684-8700 |
| 1184951600 | ELICIA ARIEL PARVIN KIMSEY PA-C Individual | Physician Assistant | 48 HILLS CREEK RD TAYLORSVILLE, GA 30178 (770) 684-8700 |
| 1235173485 | MARYANN N MUGO MD Individual | Internal Medicine (Endocrinology, Diabetes & Metabolism) | 48 HILLS CREEK RD TAYLORSVILLE, GA 30178 (770) 684-8700 |
| 1134238827 | DR. DAWN D SMILEY-BYRD MD Individual | Internal Medicine (Endocrinology, Diabetes & Metabolism) | 48 HILLS CREEK RD TAYLORSVILLE, GA 30178 (770) 684-8700 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1336682319, enumerated in the NPI registry as an "individual" on November 23, 2016
The provider is located at 48 Hills Creek Rd Taylorsville, Ga 30178 and the phone number is (770) 684-8700
The provider's speciality is Physician Assistant with taxonomy code 363A00000X
The provider has more than 10 years of experience. She graduated from Lincoln Memorial University Medical Department in 2016.
The provider might be accepting Accepts: Alliant Health Plans, Inc.. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
Medicare beneficiaries should expect a typical cost of $83.23 with an average copayment of $20.8 for new patient appointments. Established patients should expect a typical charge of $66.89 and an average copayment of 16.72. Please review your insurance plan or contact the provider directly to determine your specific costs.
The most common procedures or services performed by this practitioner are: Automated urinalysis test, Established patient office or other outpatient visit, 20-29 minutes, Established patient office or other outpatient visit, 30-39 minutes, Injection of drug or substance under skin or into muscle, Injection, dexamethasone sodium phosphate, 1 mg and Insertion of needle into vein for collection of blood sample.
The practitioner is affiliated to the following hospital(s): ATRIUM HEALTH FLOYD MEDICAL CENTER. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.
This NPI record was last updated on November 23, 2016. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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