Individual provider Active NPI

Tonya Pepper, P.A.-C

  • Physician Assistant
  • Lithia Springs, GA
National Provider Identifier
1083626493
Registry record updated Oct 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA04195 Issued in TX
Practice address
644 Thornton Rd
Lithia Springs, GA 30122
Phone
(678) 915-9887
NPI assigned
Aug 13, 2006
Last updated
Oct 8, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA04195 TX Primary

Addresses

Primary practice location

644 Thornton Rd
Lithia Springs, GA 30122

Mailing address

1879 Eveningside Way NW
Kennesaw, GA 30152-4794
Phone (903) 806-6536

Other names 1

  • Tonya Dubois Former name

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240411003533 GA Practitioner - Physician Assistant 4587627013 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellstar Medical Group LLCGroup PAC ID 6709065402, 3,059 clinicians
Wellstreet of Georgia PCGroup PAC ID 7517126279, 425 clinicians

Practice addresses (Care Compare)

120 Greystone Power Blvd
Suite 110
Dallas, GA 30157-8297
Phone (470) 267-1540

2292 Peachtree Rd
Atlanta, GA 30309-1147
Phone (404) 382-9941

2505 Dallas Hwy SW
Marietta, GA 30064-2659
Phone (678) 956-6230

500 Nathan Dean Blvd
Suite 105
Dallas, GA 30157-4911
Phone (470) 624-6793

5749 Wendy Bagwell Pkwy
Hiram, GA 30141-2815
Phone (470) 523-4130

Merit-based Incentive Payment System (MIPS)

Final score
94.51 of 100Reported as apm
Quality
80.61
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
91.62 of 100Reported as apm
Quality
83.25
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA04195TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Wellstreet of Georgia PC CurrentSince Aug 2, 2024 Accepting new patients
East Texas Medical Center Healthcare Associates Physician Assistant Past Accepting new patients
Peachtree Immediate Care UC, LLC PastSince Apr 21, 2024 Accepting new patients
Exceed Health Clinic PastSince Feb 21, 2021 Accepting new patients

Locations

2292 Peachtree Rd NW
Atlanta, GA 30309
Phone (404) 382-9941

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/6966/brand/1/csg/1/fhir/r4

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1155427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759881600000",
    "number": "1083626493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1879 EVENINGSIDE WAY NW",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301524794",
            "telephone_number": "903-806-6536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "644 THORNTON RD",
            "city": "LITHIA SPRINGS",
            "state": "GA",
            "postal_code": "30122",
            "telephone_number": "678-915-9887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEPPER",
        "first_name": "TONYA",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-13",
        "last_updated": "2025-10-08",
        "certification_date": "2025-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA04195",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TONYA",
            "last_name": "DUBOIS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lithia Springs, GA

Sources for this page

Verify at the official NPI Registry.