Jacob Carson, CSFA

Primary specialty

Surgical AssistantTaxonomy code 246ZC0007X

License

213549 Issued in GA

Practice address

5341 Holly Springs Pkwy Ste 207-106
Woodstock, GA 30188-2492

Phone

(214) 227-2457

Fax

(214) 764-0880

NPI assigned

Oct 27, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Jscsurgical, LLC

  • Surgical Assistant
  • Woodstock, GA
  • NPI 1861248734
  NPD Authorized official

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

{
    "created_epoch": "1666828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717977600000",
    "number": "1174230320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2550",
            "city": "ROWLETT",
            "state": "TX",
            "postal_code": "750302550",
            "telephone_number": "214-227-2457",
            "fax_number": "214-764-0880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5341 HOLLY SPRINGS PKWY STE 207-106",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301882492",
            "telephone_number": "214-227-2457",
            "fax_number": "214-764-0880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARSON",
        "first_name": "JACOB",
        "name_prefix": "Mr.",
        "credential": "CSFA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-10-27",
        "last_updated": "2024-06-10",
        "certification_date": "2024-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZC0007X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Assistant",
            "state": "GA",
            "license": "213549",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "advancedsurgicalsolutions.com",
            "affiliation": "N",
            "endpointDescription": "Office",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1700 Medical Way",
            "city": "Snellville",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300782195",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Amber Carlson
• Ian Carlson, DMD
• Aubrey Carr, PT, DPT, ATC
• Lindsey Carr
• Clayton O Carroll, PT, DPT, SCS
• Leroy Carswell I, CADC T
• Sam Reiser Caruso, DMD
• Jennifer Nicole Case, DO
• Steven Castellanos, PHARMD
• Deidra Lynn Castillo, COTA/L

• Surgical Assistant in Woodstock, GA
• Providers in Woodstock, GA by specialty
• Surgical Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.