Anna Leigh Vonck, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

11341 Issued in GA

Practice address

6300 Hospital Pkwy Ste 100
Duluth, GA 30097-1829

Phone

(707) 716-5917

NPI assigned

Nov 4, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

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

Specialty

Physician Assistant

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Johns Creek Dermatology and Family Medicine, P.C.Group PAC ID 2668521048, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/DGBGAA/Endpoint/DGBGAA
• Direct secure messaging: avonack@directaddress.net

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.

• Johns Creek Dermatology and Family Medicine, P.C.

  • Dermatology Physician
  • Johns Creek, GA
  • NPI 1053565580
  Medicare reassignment Care Compare group
• Springs Dermatology, LLC

  • Dermatopathology Physician
  • Sandy Springs, GA
  • NPI 1679158885
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1604448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683763200000",
    "number": "1023619129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6300 HOSPITAL PKWY STE 100",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300971829",
            "telephone_number": "770-771-6591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6300 HOSPITAL PKWY STE 100",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300971829",
            "telephone_number": "707-716-5917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VONCK",
        "first_name": "ANNA",
        "middle_name": "LEIGH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-04",
        "last_updated": "2023-05-11",
        "certification_date": "2023-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "025874",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "11341",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OFFICE OF THE PROFESSIONS LICENSURE/REGISTRATION NUMBER",
            "identifier": "025874",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCCPA CERTIFICATION NUMBER",
            "identifier": "1177899",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gina Vines, LPC
• Vision Expo Pdy Inc
• Vision One Eye Care Duluth LLC
• Visionary 2020 LLLP
• Vitalpoint Medical Devices LLC
• Patrick J Voswinkel, M.D.
• Tammy Vu
• Lauren Wah, OTR/L
• Marc Wahlquist, M.D.
• Wal-Mart Stores East LP

• Physician Assistant in Duluth, GA
• Providers in Duluth, GA by specialty
• Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.