Carline A Fenelus, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

004624 Issued in GA

Practice address

6600 Van Aalst Blvd
Fort Moore, GA 31905-2102

Phone

(706) 544-8830

Fax

(762) 408-8169

NPI assigned

Sep 28, 2006

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 names 1

• Mrs. Carline Ariol Fenelus Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738022400000",
    "number": "1447342688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12493 HUNTINGTON TRACE LN",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300058799",
            "telephone_number": "678-242-0332",
            "fax_number": "678-242-0332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6600 VAN AALST BLVD",
            "city": "FORT MOORE",
            "state": "GA",
            "postal_code": "319052102",
            "telephone_number": "706-544-8830",
            "fax_number": "762-408-8169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FENELUS",
        "first_name": "CARLINE",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-28",
        "last_updated": "2025-01-28",
        "certification_date": "2025-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "005311-01",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "004624",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CARLINE",
            "last_name": "FENELUS",
            "middle_name": "ARIOL",
            "prefix": "MRS.",
            "credential": "PHYSICIAN ASSISTANT",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Antonio Danilo Espinal
• Jenna Irene Evans, LCSW
• Charleston Faglie
• Cindy Sue Falk, MCD,CCC-SLP
• Katrina Farrell, APRN
• Find the Path Counseling and Supervision
• Alexander Fleming, MS, ATC, CES, PES
• Samantha Ruth Flint, LCSW, LISW
• William Camp Fortson, M.D.
• Jenna Elizabeth Frost, PA-C

• Physician Assistant in Fort Moore, GA
• Providers in Fort Moore, GA by specialty
• Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2025; 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.