Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Canon Tate Rooker, PA

Individual provider Physician Assistant · NPI 1669130852

Canon Tate Rooker, PA is a Physician Assistant in Sandy Springs, Georgia. Qualified in 2021, 5 years ago. Practices with Piedmont Providers LLC, a 518-clinician group and accepts Medicare assignment.

Years since qualifying
5
In the registry since
2021
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

1150 Hammond Dr Ste 400
Sandy Springs, GA 30328-8617
Phone: (404) 256-2633
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1669130852
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedDecember 4, 2021
Last updated in NPPESDecember 4, 2021
Certification dateDecember 4, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Piedmont Providers Llc — 518 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

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