Charice Wilson Jordan, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

6661 Issued in GA

Practice address

939 Thornton Rd
Lithia Springs, GA 30122-2634

Phone

(770) 948-5400

NPI assigned

Oct 19, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Charice Wilson Former name

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cjordan91940@direct.emory.org

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.

• The Emory Clinic Inc

  • Internal Medicine Physician
  • Atlanta, GA
  • NPI 1396798229
  Medicare reassignment
• Southside Medical Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Atlanta, GA
  • NPI 1235123993
  NPD

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

{
    "created_epoch": "1350604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780012800000",
    "number": "1205189859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 761",
            "city": "LITHIA SPRINGS",
            "state": "GA",
            "postal_code": "301220761",
            "telephone_number": "904-566-8851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "939 THORNTON RD",
            "city": "LITHIA SPRINGS",
            "state": "GA",
            "postal_code": "301222634",
            "telephone_number": "770-948-5400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "CHARICE",
        "middle_name": "WILSON",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-19",
        "last_updated": "2026-05-29",
        "certification_date": "2026-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "6661",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHARICE",
            "last_name": "WILSON",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Otis Franflyn Johnson
• Temeka L Johnson
• Zachary Johnson, COF
• Shevon Jones
• Jonvi Cares LLC
• Morgan Joseph, MD
• Lauren Lewis Judah, M.D.
• Judith Ruth Medical Center LLC
• Mark William Justice, D.M.D.
• Kendi Beauty LLC

• Physician Assistant in Lithia Springs, GA
• Providers in Lithia Springs, 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 29, 2026; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.